| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $231.49 | $252.71 | |
Aetna
| Facility | 25 | $98.02 | $176.00 | $334.94 |
CareSource
| Facility | $10.86 | $14.12 | $22.10 |
Emergency Department Visit May Not Req Phys/Qhp
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $231.49 | $252.71 | |
Aetna
| Facility | 25 | $98.02 | $176.00 | $334.94 |
CareSource
| Facility | $10.86 | $14.12 | $22.10 |