| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.52 | $115.52 | $8,500.00 | |
Medica
| Facility | $115.52 | $158.16 | $337.41 | |
United
| Facility | $681.00 | $681.00 | $681.00 |
Sgmdsc Flx W/Dcmprn W/Plmt Dcmprn Tube
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.52 | $115.52 | $8,500.00 | |
Medica
| Facility | $115.52 | $158.16 | $337.41 | |
United
| Facility | $681.00 | $681.00 | $681.00 |