| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,454.71 | $2,454.71 | $2,454.71 |
Restorigin, 1 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,454.71 | $2,454.71 | $2,454.71 |