| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $63.10 | $169.82 | $245.47 | |
BCBS
| Facility | $38.90 | $52.48 | $114.82 | |
Cigna
| Facility | $147.91 | $147.91 | $147.91 | |
Medica
| Facility | $63.10 | $63.10 | $63.10 |
Other Therapeutic Services (see also 095X, an extension of 094X)-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $63.10 | $169.82 | $245.47 | |
BCBS
| Facility | $38.90 | $52.48 | $114.82 | |
Cigna
| Facility | $147.91 | $147.91 | $147.91 | |
Medica
| Facility | $63.10 | $63.10 | $63.10 |