| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,240.83 | $1,450.02 | $2,338.83 | |
Cigna
| Professional | $533.86 | $1,214.21 | $1,379.79 | |
Medica
| Facility | $1,803.64 | $1,803.64 | $1,803.64 | |
Medica
| Professional | $2,254.55 | $2,254.55 | $2,254.55 | |
Molina
| Professional | $58.40 | $58.40 | $58.40 | |
Quartz
| Professional | $884.37 | $884.37 | $1,307.64 | |
Quartz
| Facility | $901.82 | $1,803.64 | $1,803.64 | |
Quartz
| Professional | $1,803.64 | $2,254.55 | $2,254.55 |