| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.56 | $155.72 | $232.54 | |
BCBS
| Professional | $17.50 | $21.22 | $23.07 | |
Cigna
| Professional | $43.50 | $43.50 | $43.50 | |
Medica
| Facility | $123.59 | $135.94 | $232.54 |
Level 1 hospital emergency department visit provided in a type B emergency department; (the ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 CFR 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.56 | $155.72 | $232.54 | |
BCBS
| Professional | $17.50 | $21.22 | $23.07 | |
Cigna
| Professional | $43.50 | $43.50 | $43.50 | |
Medica
| Facility | $123.59 | $135.94 | $232.54 |