| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $32.40 | $32.40 | $116.49 | |
Cigna
| Facility | $76.50 | $76.50 | $90.00 |
Rural/Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $32.40 | $32.40 | $116.49 | |
Cigna
| Facility | $76.50 | $76.50 | $90.00 |