| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $296.52 | $1,492.02 | $2,088.83 | |
Providence
| Facility | $297.20 | $1,492.02 | $2,088.83 |
Impltj/Rplcmt Ithcl/Edrl Drug Nfs Subq Rsvr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $296.52 | $1,492.02 | $2,088.83 | |
Providence
| Facility | $297.20 | $1,492.02 | $2,088.83 |