| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,736.36 | $2,736.36 | |
CareSource
| Facility | $3,074.99 | $3,537.40 | $3,854.05 | |
Cigna
| Facility | $3,303.79 | $3,303.79 | $3,303.79 |
Rescj/Exc Les Itprl Fossa Space Apex Idrl W/Rpr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,736.36 | $2,736.36 | |
CareSource
| Facility | $3,074.99 | $3,537.40 | $3,854.05 | |
Cigna
| Facility | $3,303.79 | $3,303.79 | $3,303.79 |