| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.68 | $30,199.52 | $30,902.95 | |
BCBS
| Facility | $100.00 | $2,137.96 | $3,890.45 | |
Cigna
| Facility | $645.65 | $2,511.89 | $33,113.11 |
Other Therapeutic Services (see also 095X, an extension of 094X)-Other Therapeutic Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.68 | $30,199.52 | $30,902.95 | |
BCBS
| Facility | $100.00 | $2,137.96 | $3,890.45 | |
Cigna
| Facility | $645.65 | $2,511.89 | $33,113.11 |
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