| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $9.19 | $17.50 | |
Moda Health
| Facility | $6.57 | $7.26 | $8.41 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |
Addl Supl Matrl&Staf Tm Drg Phe Res-Tr Nfct Ds
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $9.19 | $17.50 | |
Moda Health
| Facility | $6.57 | $7.26 | $8.41 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |