| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,603.11 | $6,603.11 | $6,603.11 | |
Martin's Point
| Facility | $6,603.11 | $6,603.11 | $6,603.11 |
Revj Opn Arven Fstl W/Thrmbc Dial Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,603.11 | $6,603.11 | $6,603.11 | |
Martin's Point
| Facility | $6,603.11 | $6,603.11 | $6,603.11 |