| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.00 | $128.00 | $128.00 |
Hospital Ip/Obs Care Same Date Sf/Low Mdm 45 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.00 | $128.00 | $128.00 |