| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $31.62 | $93.33 | |
Medica
| Professional | $162.18 | $162.18 | $162.18 |
Unlisted preventive medicine service
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $31.62 | $93.33 | |
Medica
| Professional | $162.18 | $162.18 | $162.18 |