| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $87.05 | $87.05 | $104.30 | |
Priority Health
| Professional | $87.05 | $87.05 | $104.30 |
Ifxj Loclz&Trakg Trgt/Pt Mtn Dur Radtx Ea Fxj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $87.05 | $87.05 | $104.30 | |
Priority Health
| Professional | $87.05 | $87.05 | $104.30 |