| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.96 | $245.96 | $328.00 | |
Kaiser Permanente
| Professional | $135.00 | $195.00 | $249.00 |
Daily Hosp Mgmt Edrl/Sarach Cont Drug Admn
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.96 | $245.96 | $328.00 | |
Kaiser Permanente
| Professional | $135.00 | $195.00 | $249.00 |