| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,621.00 | $3,748.00 | $4,345.00 | |
Medica
| Facility | $2,500.00 | $2,500.00 | $2,500.00 |
Treatment/Observation Room - Other Treatment/Observation Rm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,621.00 | $3,748.00 | $4,345.00 | |
Medica
| Facility | $2,500.00 | $2,500.00 | $2,500.00 |