| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $67.95 | $67.95 | $115.52 | |
Cigna
| Facility | $49.00 | $52.00 | $56.00 |
Rural/Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $67.95 | $67.95 | $115.52 | |
Cigna
| Facility | $49.00 | $52.00 | $56.00 |