| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $310.08 | $310.08 | $8,500.00 | |
Medica
| Facility | $310.08 | $433.85 | $527.15 |
Ostpl Rcnstj Dorsal Spi Elmnts Flwg Ispi Px
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $310.08 | $310.08 | $8,500.00 | |
Medica
| Facility | $310.08 | $433.85 | $527.15 |