| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $71.81 | $195.62 | $272.64 | |
Cigna
| Facility | $42.00 | $42.00 | $42.00 |
Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $71.81 | $195.62 | $272.64 | |
Cigna
| Facility | $42.00 | $42.00 | $42.00 |