| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $114.90 | $114.90 | $147.01 | |
Fallon Health
| Facility | $60.00 | $3,504.00 | $9,239.00 |
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 | $114.90 | $114.90 | $147.01 | |
Fallon Health
| Facility | $60.00 | $3,504.00 | $9,239.00 |