| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $218.78 | $331.13 | $524.81 | |
Providence
| Facility | $218.78 | $295.12 | $562.34 |
Plt, aph/pher, l/r, cmv-neg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $218.78 | $331.13 | $524.81 | |
Providence
| Facility | $218.78 | $295.12 | $562.34 |