| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $660.69 | $660.69 | $1,174.90 | |
Aetna
| Professional | $660.69 | $660.69 | $660.69 | |
Medical Mutual of Ohio
| Facility | $371.54 | $371.54 | $549.54 |
Hemostatic agent, gastrointestinal, topical
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $660.69 | $660.69 | $1,174.90 | |
Aetna
| Professional | $660.69 | $660.69 | $660.69 | |
Medical Mutual of Ohio
| Facility | $371.54 | $371.54 | $549.54 |