| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $297.06 | $297.06 | $297.06 | |
Pacific Source
| Facility | $272.44 | $272.44 | $79,999.20 | |
United
| Professional | $631.04 | $631.04 | $688.42 |
Paramedic intercept (PI), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third-party payers
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $297.06 | $297.06 | $297.06 | |
Pacific Source
| Facility | $272.44 | $272.44 | $79,999.20 | |
United
| Professional | $631.04 | $631.04 | $688.42 |