| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $528.80 | $719.13 | $928.50 | |
Providence
| Facility | $528.80 | $719.13 | $1,266.69 |
Level 4 Imaging without Contrast
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $528.80 | $719.13 | $928.50 | |
Providence
| Facility | $528.80 | $719.13 | $1,266.69 |