| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40,738.03 | $40,738.03 | $40,738.03 |
Operating Room Services-Other OR services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40,738.03 | $40,738.03 | $40,738.03 |