| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $218.78 | $218.78 | |
BCBS
| Facility | $54.95 | $77.62 | $162.18 |
Professional Fees (Extension of 096X and 097X)-Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $218.78 | $218.78 | |
BCBS
| Facility | $54.95 | $77.62 | $162.18 |
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