| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $31.81 | $50.00 | $50.00 | |
Medica
| Facility | $31.81 | $31.81 | $32.76 |
Nonemergency transportation and bus, intra- or interstate carrier
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $31.81 | $50.00 | $50.00 | |
Medica
| Facility | $31.81 | $31.81 | $32.76 |