| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $69.18 | $173.78 | $245.47 | |
Cigna
| Facility | $91.20 | $91.20 | $91.20 |
Clinic-General classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $69.18 | $173.78 | $245.47 | |
Cigna
| Facility | $91.20 | $91.20 | $91.20 |