| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.00 | $148.00 | $175.00 | |
Ambetter
| Facility | $884.33 | $884.33 | $884.33 | |
Cigna
| Facility | $238.00 | $238.00 | $238.00 |
Other Imaging Services-Other Imaging Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.00 | $148.00 | $175.00 | |
Ambetter
| Facility | $884.33 | $884.33 | $884.33 | |
Cigna
| Facility | $238.00 | $238.00 | $238.00 |