| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.90 | $30.90 | $30.90 | |
Aetna
| Professional | $10.00 | $30.90 | $30.90 | |
Anthem BCBS
| Professional | $25.12 | $25.12 | $81.28 | |
SummaCare
| Professional | $60.26 | $60.26 | $60.26 |
Nonemergency transportation and bus, intra- or interstate carrier
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.90 | $30.90 | $30.90 | |
Aetna
| Professional | $10.00 | $30.90 | $30.90 | |
Anthem BCBS
| Professional | $25.12 | $25.12 | $81.28 | |
SummaCare
| Professional | $60.26 | $60.26 | $60.26 |