| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $38.00 | $93.00 | $103.00 | |
Priority Health
| Facility | $38.00 | $93.00 | $103.00 |
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 | $38.00 | $93.00 | $103.00 | |
Priority Health
| Facility | $38.00 | $93.00 | $103.00 |