| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $332.94 | $332.94 | $332.94 | |
Wellpoint
| Professional | $13.34 | $13.34 | $13.34 |
Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $332.94 | $332.94 | $332.94 | |
Wellpoint
| Professional | $13.34 | $13.34 | $13.34 |