| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $10.52 | $10.52 | $15.29 | |
Cigna
| Facility | $42.35 | $49.49 | $75.92 | |
Cigna
| Professional | $17.35 | $41.17 | $46.79 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 | |
Quartz
| Professional | $30.12 | $30.12 | $44.34 | |
Quartz
| Facility | $70.00 | $70.00 | $90.00 |