| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $150.50 | $150.50 | $150.50 | |
Cigna
| Professional | $150.50 | $150.50 | $150.50 | |
United
| Facility | $145.53 | $145.53 | $145.53 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $150.50 | $150.50 | $150.50 | |
Cigna
| Professional | $150.50 | $150.50 | $150.50 | |
United
| Facility | $145.53 | $145.53 | $145.53 |