| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $62.00 | $108.00 | $114.00 | |
Hally Health
| Facility | $100.00 | $125.00 | $345.40 |
Freestanding Clinic-Visit by RHC/FQHC Practitioner to a Member in a SNF (Not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $62.00 | $108.00 | $114.00 | |
Hally Health
| Facility | $100.00 | $125.00 | $345.40 |