| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $217.97 | $217.97 | $217.97 | |
MVP Health Care
| Facility | $217.97 | $217.97 | $217.97 |
Unlisted Diagnostic Radiographic Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $217.97 | $217.97 | $217.97 | |
MVP Health Care
| Facility | $217.97 | $217.97 | $217.97 |