| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.45 | $71.45 | $71.45 | |
Aetna
| Professional | $49.09 | $51.58 | $51.58 | |
Cigna
| Professional | $71.45 | $71.45 | $89.31 | |
United
| Professional | $21.75 | $26.10 | $62.14 |
Rx Assay Prsmv 30+Rx/Metablt Ur Lc-Ms/Ms Mrm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.45 | $71.45 | $71.45 | |
Aetna
| Professional | $49.09 | $51.58 | $51.58 | |
Cigna
| Professional | $71.45 | $71.45 | $89.31 | |
United
| Professional | $21.75 | $26.10 | $62.14 |