| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $30.24 | $373.47 | $1,625.36 | |
Cigna
| Facility | $68.25 | $68.25 | $68.25 |
Clinic-Pediatric Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $30.24 | $373.47 | $1,625.36 | |
Cigna
| Facility | $68.25 | $68.25 | $68.25 |