| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.83 | $20.83 | $20.83 | |
Aetna
| Professional | $20.83 | $20.83 | $20.83 | |
Cigna
| Facility | $60.00 | $70.00 | $85.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |
Php/Iop Ot Service
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.83 | $20.83 | $20.83 | |
Aetna
| Professional | $20.83 | $20.83 | $20.83 | |
Cigna
| Facility | $60.00 | $70.00 | $85.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |