| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $526.00 | $526.00 | $526.00 | |
Ambetter
| Facility | $2,979.90 | $2,979.90 | $2,979.90 |
Acquisition of Body Components-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $526.00 | $526.00 | $526.00 | |
Ambetter
| Facility | $2,979.90 | $2,979.90 | $2,979.90 |