| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $111.41 | $116.87 | $187.53 | |
Cigna
| Professional | $104.86 | $154.56 | $248.33 | |
United
| Professional | $146.38 | $189.44 | $394.25 |
Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $111.41 | $116.87 | $187.53 | |
Cigna
| Professional | $104.86 | $154.56 | $248.33 | |
United
| Professional | $146.38 | $189.44 | $394.25 |