| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $981.23 | $1,334.36 | $1,722.86 | |
Providence
| Facility | $981.23 | $1,334.36 | $2,350.40 |
Level 4 Diagnostic Tests and Related Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $981.23 | $1,334.36 | $1,722.86 | |
Providence
| Facility | $981.23 | $1,334.36 | $2,350.40 |