| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $195.58 | $195.58 | $195.58 | |
Aetna
| Professional | $191.34 | $241.29 | $465.90 | |
Horizon BCBS
| Facility | $792.43 | $792.43 | $981.93 |
Level 5 Hospital Type B Ed Visit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $195.58 | $195.58 | $195.58 | |
Aetna
| Professional | $191.34 | $241.29 | $465.90 | |
Horizon BCBS
| Facility | $792.43 | $792.43 | $981.93 |