| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.06 | $85.95 | $776.64 | |
Aetna
| Professional | $47.06 | $85.95 | $776.64 | |
MVP Health Care
| Facility | $555.00 | $597.00 | $74,999.25 |
Breast prosthesis, not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.06 | $85.95 | $776.64 | |
Aetna
| Professional | $47.06 | $85.95 | $776.64 | |
MVP Health Care
| Facility | $555.00 | $597.00 | $74,999.25 |