| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,281.94 | $2,281.94 | $2,281.94 | |
Priority Health
| Facility | $2,281.94 | $2,281.94 | $2,281.94 |
Level 4 Diagnostic Tests and Related Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,281.94 | $2,281.94 | $2,281.94 | |
Priority Health
| Facility | $2,281.94 | $2,281.94 | $2,281.94 |