| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $300.00 | $552.00 | $1,133.00 | |
Priority Health
| Facility | $175.00 | $700.00 | $1,133.00 |
Capd / Composite Or Other Ra
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $300.00 | $552.00 | $1,133.00 | |
Priority Health
| Facility | $175.00 | $700.00 | $1,133.00 |