| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $55.10 | $55.10 | $55.10 | |
Medica
| Facility | $12.06 | $12.06 | $12.06 | |
Medica
| Professional | $53.94 | $53.94 | $53.94 |
Unlisted In Vivo Labortory Service
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $55.10 | $55.10 | $55.10 | |
Medica
| Facility | $12.06 | $12.06 | $12.06 | |
Medica
| Professional | $53.94 | $53.94 | $53.94 |