| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.12 | $0.12 | $0.12 | |
Aetna
| Professional | $0.12 | $0.12 | $0.12 | |
Moda Health
| Facility | $0.12 | $0.12 | $0.15 | |
Molina
| Professional | $30.00 | $30.00 | $3,500.00 |
Microcapillary tube sealant
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.12 | $0.12 | $0.12 | |
Aetna
| Professional | $0.12 | $0.12 | $0.12 | |
Moda Health
| Facility | $0.12 | $0.12 | $0.15 | |
Molina
| Professional | $30.00 | $30.00 | $3,500.00 |