| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,795.00 | $2,795.00 | $2,795.00 | |
Pacific Source
| Facility | $76.16 | $350.20 | $907.12 |
Other Imaging Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,795.00 | $2,795.00 | $2,795.00 | |
Pacific Source
| Facility | $76.16 | $350.20 | $907.12 |