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BENEFIT SUMMARY - Cigna

Emergency Room Includes Professional, X-ray and/or Lab services performed at the Emergency Room and billed by the facility as part of the ER visit. Per visit copay is waived if admitted. An additional per scan copay of $65 applies to Advanced Radiological Imaging. $250 copay, and plan pays 100% ^ $250 copay, and plan pays 100% ^

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  Room, Emergency, Cigna, Emergency room

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