| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $89.22 | $121.32 | $156.65 | |
Providence
| Facility | $89.22 | $121.32 | $213.70 |
Level 2 Health and Behavior Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $89.22 | $121.32 | $156.65 | |
Providence
| Facility | $89.22 | $121.32 | $213.70 |