| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $874.00 | $874.00 | $874.00 | |
Priority Health
| Facility | $874.00 | $874.00 | $874.00 |
Radiology - Therapeutic - Other
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $874.00 | $874.00 | $874.00 | |
Priority Health
| Facility | $874.00 | $874.00 | $874.00 |