| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $195.58 | $195.58 | $195.58 | |
Aetna
| Professional | $195.58 | $291.48 | $631.14 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |
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 | $195.58 | $291.48 | $631.14 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |