| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $289.04 | $289.04 | $289.04 | |
Priority Health
| Facility | $289.04 | $289.04 | $289.04 |
Clinic Visits and Related Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $289.04 | $289.04 | $289.04 | |
Priority Health
| Facility | $289.04 | $289.04 | $289.04 |