| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $264.23 | $264.23 | $264.23 | |
Moda Health
| Facility | $267.95 | $326.39 | $368.84 |
Hospital Ip/Obs Care Same Date High Mdm 85 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $264.23 | $264.23 | $264.23 | |
Moda Health
| Facility | $267.95 | $326.39 | $368.84 |