| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.39 | $15.39 | $15.39 | |
Aetna
| Professional | $14.12 | $15.39 | $28.70 |
Re-Evaluation - Limited Problem Focused
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.39 | $15.39 | $15.39 | |
Aetna
| Professional | $14.12 | $15.39 | $28.70 |