| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.16 | $178.75 | $741.72 | |
Aetna
| Facility | 25 | $131.25 | $147.56 | $202.30 |
Emergency Department Visit May Not Req Phys/Qhp
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.16 | $178.75 | $741.72 | |
Aetna
| Facility | 25 | $131.25 | $147.56 | $202.30 |