| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $771.40 | $771.40 | $8,500.00 | |
Medica
| Facility | $771.40 | $1,049.21 | $2,314.19 |
Crtj Arven Fstl Xcp Dir Arven Anast Autog Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $771.40 | $771.40 | $8,500.00 | |
Medica
| Facility | $771.40 | $1,049.21 | $2,314.19 |