| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $64.57 | $64.57 | |
Aetna
| Professional | $64.57 | $64.57 | $64.57 | |
Molina
| Professional | $32.36 | $50.12 | $60.26 | |
SummaCare
| Professional | $50.12 | $60.26 | $75.86 |
Coordinated care fee, risk adjusted maintenance, Level 4
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $64.57 | $64.57 | |
Aetna
| Professional | $64.57 | $64.57 | $64.57 | |
Molina
| Professional | $32.36 | $50.12 | $60.26 | |
SummaCare
| Professional | $50.12 | $60.26 | $75.86 |