| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,190.09 | $1,190.09 | $1,190.09 | |
Priority Health
| Facility | $1,190.09 | $1,190.09 | $1,190.09 |
Level 3 Diagnostic Tests and Related Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,190.09 | $1,190.09 | $1,190.09 | |
Priority Health
| Facility | $1,190.09 | $1,190.09 | $1,190.09 |