| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,454.71 | $20,417.38 | $28,840.32 | |
Aetna
| Professional | $2,398.83 | $2,398.83 | $2,398.83 | |
Anthem BCBS
| Professional | $89.13 | $112.20 | $112.20 |
Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,454.71 | $20,417.38 | $28,840.32 | |
Aetna
| Professional | $2,398.83 | $2,398.83 | $2,398.83 | |
Anthem BCBS
| Professional | $89.13 | $112.20 | $112.20 |