| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $840.00 | $840.00 | $840.00 | |
Cigna
| Facility | $3,494.00 | $3,494.00 | $3,494.00 | |
Pacific Source
| Facility | $158.00 | $2,000.00 | $6,300.00 |
Emergency Room-Other
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $840.00 | $840.00 | $840.00 | |
Cigna
| Facility | $3,494.00 | $3,494.00 | $3,494.00 | |
Pacific Source
| Facility | $158.00 | $2,000.00 | $6,300.00 |