| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.37 | $239.37 | $239.37 | |
Aetna
| Professional | $239.37 | $239.37 | $659.93 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Sealant, pulmonary, liquid
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.37 | $239.37 | $239.37 | |
Aetna
| Professional | $239.37 | $239.37 | $659.93 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |