| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.91 | $84.91 | $84.91 | |
Cigna
| Facility | $386.22 | $386.22 | $386.22 | |
Providence
| Facility | $386.22 | $386.22 | $386.22 |
Unlisted diagnostic radiographic procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.91 | $84.91 | $84.91 | |
Cigna
| Facility | $386.22 | $386.22 | $386.22 | |
Providence
| Facility | $386.22 | $386.22 | $386.22 |