| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $22.99 | $22.99 | $28.73 | |
Well Sense
| Professional | $2,500.00 | $3,000.00 | $4,410.00 |
Hosp Outpt Clinic Spec Collect
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $22.99 | $22.99 | $28.73 | |
Well Sense
| Professional | $2,500.00 | $3,000.00 | $4,410.00 |