| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $213.80 | $218.78 | |
BCBS
| Facility | $162.18 | $2,137.96 | $4,073.80 |
Other Therapeutic Services (see also 095X, an extension of 094X)-Complex Medical Equipment-Routine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $213.80 | $218.78 | |
BCBS
| Facility | $162.18 | $2,137.96 | $4,073.80 |
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