| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $191.14 | $192.80 | $398.79 | |
Cigna
| Facility | $332.00 | $332.00 | $332.00 |
Clinic-General classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $191.14 | $192.80 | $398.79 | |
Cigna
| Facility | $332.00 | $332.00 | $332.00 |