| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $207.48 | $207.48 | $207.48 | |
Priority Health
| Facility | $207.48 | $207.48 | $207.48 |
Level 2 Health and Behavior Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $207.48 | $207.48 | $207.48 | |
Priority Health
| Facility | $207.48 | $207.48 | $207.48 |