| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,403.43 | $7,695.63 | $16,467.00 | |
Medcost
| Facility | $2,846.53 | $3,844.00 | $6,535.25 | |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |
Rescj/Exc Les Itprl Fossa Space Apex Idrl W/Rpr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,403.43 | $7,695.63 | $16,467.00 | |
Medcost
| Facility | $2,846.53 | $3,844.00 | $6,535.25 | |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |