| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $258.00 | $258.00 | $258.00 | |
Providence
| Facility | $258.00 | $258.00 | $258.00 |
Psychiatric Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $258.00 | $258.00 | $258.00 | |
Providence
| Facility | $258.00 | $258.00 | $258.00 |