| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.00 | $428.58 | $5,098.85 | |
Aetna
| Facility | 25 | $389.34 | $492.13 | $655.85 |
Emergency Department Visit May Not Req Phys/Qhp
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.00 | $428.58 | $5,098.85 | |
Aetna
| Facility | 25 | $389.34 | $492.13 | $655.85 |