| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $30.00 | $30.00 | |
Ambetter
| Facility | $99.93 | $99.93 | $99.93 | |
Cigna
| Facility | $49.00 | $52.00 | $56.00 |
Clinic - Pediatric Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $30.00 | $30.00 | |
Ambetter
| Facility | $99.93 | $99.93 | $99.93 | |
Cigna
| Facility | $49.00 | $52.00 | $56.00 |