| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.19 | $10.19 | $10.19 | |
Aetna
| Professional | $10.19 | $10.19 | $10.19 | |
BCBS
| Professional | $20.60 | $25.00 | $25.00 | |
United
| Professional | $19.25 | $19.25 | $19.25 |
Non-Emergency Transportation And Bus Intra Or Inter State Carrier (Not Valid For Medicare)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.19 | $10.19 | $10.19 | |
Aetna
| Professional | $10.19 | $10.19 | $10.19 | |
BCBS
| Professional | $20.60 | $25.00 | $25.00 | |
United
| Professional | $19.25 | $19.25 | $19.25 |
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