| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,511.89 | $3,890.45 | $5,754.40 | |
Aetna
| Professional | $2,089.30 | $2,398.83 | $2,511.89 | |
Emblem Health
| Professional | $38,018.94 | $38,018.94 | $38,018.94 |
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 | $2,511.89 | $3,890.45 | $5,754.40 | |
Aetna
| Professional | $2,089.30 | $2,398.83 | $2,511.89 | |
Emblem Health
| Professional | $38,018.94 | $38,018.94 | $38,018.94 |