| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,500.00 | $4,500.00 | $5,519.00 | |
Moda Health
| Facility | $1,917.66 | $3,289.50 | $5,589.70 | |
United
| Facility | $11,800.00 | $26,422.00 | $29,092.00 |
Laps Gstr Rstcv Px W/Byp&Sm Int Rcnstj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,500.00 | $4,500.00 | $5,519.00 | |
Moda Health
| Facility | $1,917.66 | $3,289.50 | $5,589.70 | |
United
| Facility | $11,800.00 | $26,422.00 | $29,092.00 |