| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $420.00 | $444.00 | |
Kaiser Permanente
| Professional | $211.23 | $211.23 | $228.00 |
Daily Hosp Mgmt Edrl/Sarach Cont Drug Admn
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $420.00 | $444.00 | |
Kaiser Permanente
| Professional | $211.23 | $211.23 | $228.00 |