| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $30.19 | $157.28 | $277.27 | |
Cigna
| Facility | $77.00 | $77.00 | $98.62 |
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 | $30.19 | $157.28 | $277.27 | |
Cigna
| Facility | $77.00 | $77.00 | $98.62 |