| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.00 | $64.00 | $64.00 | |
Aetna
| Professional | $64.00 | $64.00 | $64.00 | |
Medica
| Facility | $0.02 | $100.00 | $100.00 |
Mccd, Risk Adj, Level 4
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.00 | $64.00 | $64.00 | |
Aetna
| Professional | $64.00 | $64.00 | $64.00 | |
Medica
| Facility | $0.02 | $100.00 | $100.00 |