| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $660.98 | $660.98 | $660.98 | |
Medica
| Facility | $100.00 | $100.00 | $991.47 |
Hemostatic agent, gastrointestinal, topical
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $660.98 | $660.98 | $660.98 | |
Medica
| Facility | $100.00 | $100.00 | $991.47 |