| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $1,831.00 | $4,971.43 | |
United
| Facility | $624.00 | $1,223.00 | $5,253.00 |
Lvr Altrnsplj Orthotopic Prtl/Whl Don Any Age
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $1,831.00 | $4,971.43 | |
United
| Facility | $624.00 | $1,223.00 | $5,253.00 |