| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $153.34 | $198.66 | $300.10 |
Indiv Phys Supvj Home/Dom/R-Home Mo 30 Min/>
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $153.34 | $198.66 | $300.10 |