| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $107.15 | $107.15 | $107.15 |
Coordinated care fee, risk adjusted maintenance, Level 4
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $107.15 | $107.15 | $107.15 |