| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $20.00 | $20.00 | $20.00 | |
Cigna
| Facility | $38.76 | $38.76 | $1,100.00 |
Clinic-Other Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $20.00 | $20.00 | $20.00 | |
Cigna
| Facility | $38.76 | $38.76 | $1,100.00 |