| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $705.88 | $705.88 | $705.88 |
Ligj Divj&Strip Long Saph Saphfem Junct Kne/Belw
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $705.88 | $705.88 | $705.88 |