| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11,205.04 | $11,205.04 | $11,205.04 | |
Martin's Point
| Facility | $11,205.04 | $11,205.04 | $11,205.04 |
Crtj Arven Fstl Xcp Dir Arven Anast Nonautog Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11,205.04 | $11,205.04 | $11,205.04 | |
Martin's Point
| Facility | $11,205.04 | $11,205.04 | $11,205.04 |