| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3.20 | $7.26 | $15.00 | |
Cigna
| Professional | $119.58 | $119.58 | $150.37 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |
Addl Supl Matrl&Staf Tm Drg Phe Res-Tr Nfct Ds
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3.20 | $7.26 | $15.00 | |
Cigna
| Professional | $119.58 | $119.58 | $150.37 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |