| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
Anthem BCBS
| Professional | $61.73 | $112.57 | $114.10 | |
Martin's Point
| Professional | $2,374.87 | $2,374.87 | $2,497.23 |
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 | |
Anthem BCBS
| Professional | $61.73 | $112.57 | $114.10 | |
Martin's Point
| Professional | $2,374.87 | $2,374.87 | $2,497.23 |