| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.18 | $266.77 | $367.65 | |
Aetna
| Facility | 25 | $297.02 | $297.02 | $297.02 |
Medica
| Facility | $18.67 | $22.17 | $51.43 |
Emergency Department Visit May Not Req Phys/Qhp
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.18 | $266.77 | $367.65 | |
Aetna
| Facility | 25 | $297.02 | $297.02 | $297.02 |
Medica
| Facility | $18.67 | $22.17 | $51.43 |