| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $290.70 | $290.70 | $290.70 | |
Aetna
| Professional | $290.70 | $290.70 | $524.58 | |
United
| Professional | $441.64 | $517.62 | $833.26 |
Tdrm Gfr Mntr Snr Plmt&>1 Dos Pyrazine Ea 24 Hrs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $290.70 | $290.70 | $290.70 | |
Aetna
| Professional | $290.70 | $290.70 | $524.58 | |
United
| Professional | $441.64 | $517.62 | $833.26 |