| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $91.00 | $91.00 | $240.00 | |
Horizon BCBS
| Facility | $45.00 | $45.00 | $153.00 |
Clinic-Other Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $91.00 | $91.00 | $240.00 | |
Horizon BCBS
| Facility | $45.00 | $45.00 | $153.00 |