| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,202.26 | $1,202.26 | $1,202.26 | |
Ambetter
| Facility | $263.03 | $446.68 | $851.14 | |
Cigna
| Facility | $1,202.26 | $1,202.26 | $1,202.26 |
Other Diagnostic Services-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,202.26 | $1,202.26 | $1,202.26 | |
Ambetter
| Facility | $263.03 | $446.68 | $851.14 | |
Cigna
| Facility | $1,202.26 | $1,202.26 | $1,202.26 |