| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
Wellpoint
| Professional | $109.53 | $109.53 | $109.53 |
Injectable Bulking Agent Dextranomer/Hyaluronic Acid Copolymer Implant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
Wellpoint
| Professional | $109.53 | $109.53 | $109.53 |