| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18,055.61 | $18,055.61 | $18,055.61 | |
Martin's Point
| Facility | $18,055.61 | $18,055.61 | $18,055.61 |
Revj Transvns Intrhptc Portosystemic Shnt (Tips)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18,055.61 | $18,055.61 | $18,055.61 | |
Martin's Point
| Facility | $18,055.61 | $18,055.61 | $18,055.61 |