| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15,699.75 | $15,699.75 | $15,699.75 | |
Martin's Point
| Facility | $15,699.75 | $15,699.75 | $15,699.75 |
Revj Fem Anast Bpg Grn Opn W/Nonautog Patch Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15,699.75 | $15,699.75 | $15,699.75 | |
Martin's Point
| Facility | $15,699.75 | $15,699.75 | $15,699.75 |