| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $153.16 | $234.25 | $371.19 | |
Providence
| Facility | $207.22 | $234.25 | $371.19 |
Level 3 Health and Behavior Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $153.16 | $234.25 | $371.19 | |
Providence
| Facility | $207.22 | $234.25 | $371.19 |