| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $660.98 | $660.98 | $660.98 | |
Well Sense
| Professional | $2,500.00 | $2,750.00 | $3,500.00 |
Hemostatic agent, gastrointestinal, topical
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $660.98 | $660.98 | $660.98 | |
Well Sense
| Professional | $2,500.00 | $2,750.00 | $3,500.00 |