| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.54 | $55.54 | $122.20 | |
Aetna
| Professional | $49.12 | $55.54 | $55.54 | |
Cigna
| Facility | $55.24 | $85.40 | $96.42 |
Unlisted Therapeutic Proph/Dx Iv/Ia Njx/Nfs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.54 | $55.54 | $122.20 | |
Aetna
| Professional | $49.12 | $55.54 | $55.54 | |
Cigna
| Facility | $55.24 | $85.40 | $96.42 |