| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $228.29 | $228.29 | $1,400.00 | |
CareSource
| Facility | $266.05 | $309.55 | $337.27 | |
Cigna
| Facility | $283.50 | $283.50 | $283.50 | |
United
| Facility | $765.00 | $765.00 | $765.00 |
Evasc Intracranial Prolng Admn Rx Agent Art Addl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $228.29 | $228.29 | $1,400.00 | |
CareSource
| Facility | $266.05 | $309.55 | $337.27 | |
Cigna
| Facility | $283.50 | $283.50 | $283.50 | |
United
| Facility | $765.00 | $765.00 | $765.00 |