| 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 |
Free-Standing Clinic - Visit by RHC/FQHC practitioner to other non RHC/FQHC site (e.g. scene of accident)
| 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 |