| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.60 | $117.60 | $117.60 | |
Aetna
| Professional | $23.68 | $23.68 | $23.68 | |
Cigna
| Professional | $73.52 | $73.52 | $73.52 |
Hhcp-Serv Of Ot,Ea 15 Min
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.60 | $117.60 | $117.60 | |
Aetna
| Professional | $23.68 | $23.68 | $23.68 | |
Cigna
| Professional | $73.52 | $73.52 | $73.52 |