| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $258.00 | $258.00 | $258.00 | |
Providence
| Facility | $258.00 | $258.00 | $258.00 |
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 | $258.00 | $258.00 | $258.00 | |
Providence
| Facility | $258.00 | $258.00 | $258.00 |