| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $7.26 | $15.00 | $25.00 | |
Cigna
| Professional | $119.58 | $201.47 | $255.12 | |
Medcost
| Facility | $6.57 | $7.26 | $15.36 |
Addl Supl Matrl&Staf Tm Drg Phe Res-Tr Nfct Ds
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $7.26 | $15.00 | $25.00 | |
Cigna
| Professional | $119.58 | $201.47 | $255.12 | |
Medcost
| Facility | $6.57 | $7.26 | $15.36 |