| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $196.00 | $345.60 | $345.60 | |
CareSource
| Facility | $13.70 | $57.07 | $136.97 |
Daily Hosp Mgmt Edrl/Sarach Cont Drug Admn
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $196.00 | $345.60 | $345.60 | |
CareSource
| Facility | $13.70 | $57.07 | $136.97 |