| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.26 | $55.61 | $155.10 | |
Aetna
| Facility | 25 | $83.70 | $134.63 | $406.45 |
Cigna
| Facility | $272.00 | $272.00 | $272.00 |
Emergency Department Visit May Not Req Phys/Qhp
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.26 | $55.61 | $155.10 | |
Aetna
| Facility | 25 | $83.70 | $134.63 | $406.45 |
Cigna
| Facility | $272.00 | $272.00 | $272.00 |