| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,912.94 | $1,912.94 | $1,912.94 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |
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 | $1,912.94 | $1,912.94 | $1,912.94 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |