| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.81 | $31.81 | $31.81 | |
Aetna
| Professional | $31.81 | $31.81 | $31.81 | |
Anthem BCBS
| Professional | $18.05 | $25.00 | $72.90 |
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 | $31.81 | $31.81 | $31.81 | |
Aetna
| Professional | $31.81 | $31.81 | $31.81 | |
Anthem BCBS
| Professional | $18.05 | $25.00 | $72.90 |