| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,451.59 | $3,038.00 | $4,387.00 | |
United
| Facility | $3,028.00 | $9,753.00 | $15,824.00 |
Laps Gstr Rstcv Px W/Byp&Sm Int Rcnstj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,451.59 | $3,038.00 | $4,387.00 | |
United
| Facility | $3,028.00 | $9,753.00 | $15,824.00 |