| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $127.44 | $219.95 | $356.75 | |
Cigna
| Facility | $129.00 | $129.00 | $129.00 |
Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $127.44 | $219.95 | $356.75 | |
Cigna
| Facility | $129.00 | $129.00 | $129.00 |