| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.54 | $55.54 | $55.54 | |
Aetna
| Professional | $55.54 | $55.54 | $55.54 | |
Regence BlueShield
| Facility | $66.20 | $90.07 | $131.25 |
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 | $55.54 | |
Aetna
| Professional | $55.54 | $55.54 | $55.54 | |
Regence BlueShield
| Facility | $66.20 | $90.07 | $131.25 |