| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,133.92 | $1,133.92 | $8,500.00 | |
Medica
| Facility | $1,133.92 | $1,581.14 | $3,401.76 |
Urtp Transpubic/Prnl 1 Stg Rcnstj/Rpr Urt
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,133.92 | $1,133.92 | $8,500.00 | |
Medica
| Facility | $1,133.92 | $1,581.14 | $3,401.76 |