| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $17.35 | $17.35 | $21.68 | |
Medcost
| Professional | $12.54 | $12.54 | $12.54 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $17.35 | $17.35 | $21.68 | |
Medcost
| Professional | $12.54 | $12.54 | $12.54 |