| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $1,900.60 | $1,900.60 | $1,900.60 |
Aetna
| Facility | QX | $3,130.40 | $3,130.40 | $3,130.40 |
Anes Iper Upr Abd Prtl Hptc Mgmt Liver Hemrrg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $1,900.60 | $1,900.60 | $1,900.60 |
Aetna
| Facility | QX | $3,130.40 | $3,130.40 | $3,130.40 |