| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $103.68 | $103.68 | $103.68 | |
Priority Health
| Facility | $103.68 | $103.68 | $103.68 |
Level 1 Imaging without Contrast
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $103.68 | $103.68 | $103.68 | |
Priority Health
| Facility | $103.68 | $103.68 | $103.68 |