| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,374.87 | $2,374.87 | $3,989.18 | |
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
BCBS
| Facility | $0.02 | $0.03 | $0.03 |
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 | $2,374.87 | $2,374.87 | $3,989.18 | |
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
BCBS
| Facility | $0.02 | $0.03 | $0.03 |