| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,158.93 | $1,158.93 | $8,500.00 | |
Medica
| Facility | $1,158.93 | $1,563.17 | $3,476.79 |
Revj Fem Anast Bpg Grn Opn W/Nonautog Patch Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,158.93 | $1,158.93 | $8,500.00 | |
Medica
| Facility | $1,158.93 | $1,563.17 | $3,476.79 |