| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.49 | $50.49 | $50.49 | |
Aetna
| Professional | $50.49 | $50.49 | $50.49 | |
Cigna
| Facility | $23.92 | $23.97 | $170.74 | |
Medica
| Facility | $45.44 | $53.01 | $108.40 |
Unlisted Therapeutic Proph/Dx Iv/Ia Njx/Nfs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.49 | $50.49 | $50.49 | |
Aetna
| Professional | $50.49 | $50.49 | $50.49 | |
Cigna
| Facility | $23.92 | $23.97 | $170.74 | |
Medica
| Facility | $45.44 | $53.01 | $108.40 |