| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $213.80 | $288.40 | $302.00 | |
AmeriHealth
| Facility | $316.23 | $316.23 | $331.13 | |
Cigna
| Facility | $239.88 | $239.88 | $239.88 |
Clinic-General classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $213.80 | $288.40 | $302.00 | |
AmeriHealth
| Facility | $316.23 | $316.23 | $331.13 | |
Cigna
| Facility | $239.88 | $239.88 | $239.88 |