| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.00 | $184.00 | $184.00 | |
Cigna
| Facility | $46.00 | $52.00 | $1,286.00 |
Clinic-Pediatric Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.00 | $184.00 | $184.00 | |
Cigna
| Facility | $46.00 | $52.00 | $1,286.00 |