| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,079.96 | $2,079.96 | $2,305.84 | |
Martin's Point
| Facility | $2,079.96 | $2,079.96 | $2,305.84 |
Unlisted Procedure Hemic Or Lymphatic System
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,079.96 | $2,079.96 | $2,305.84 | |
Martin's Point
| Facility | $2,079.96 | $2,079.96 | $2,305.84 |