| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $7,838.38 | $7,838.38 | |
Providence
| Facility | $2,827.73 | $3,598.92 | $4,243.87 | |
United
| Facility | $3,085.00 | $4,262.00 | $17,636.00 |
Rescj/Exc Les Itprl Fossa Space Apex Idrl W/Rpr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $7,838.38 | $7,838.38 | |
Providence
| Facility | $2,827.73 | $3,598.92 | $4,243.87 | |
United
| Facility | $3,085.00 | $4,262.00 | $17,636.00 |