| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.58 | $25.58 | $25.58 | |
Aetna
| Professional | $25.57 | $25.58 | $25.58 |
Ambulance (Als Or Bls) Oxygen And Oxygen Supplies Life Sustaining Situation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.58 | $25.58 | $25.58 | |
Aetna
| Professional | $25.57 | $25.58 | $25.58 |