| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $87.97 | $87.97 | $99.96 | |
Quartz
| Facility | $90.00 | $90.00 | $90.00 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $87.97 | $87.97 | $99.96 | |
Quartz
| Facility | $90.00 | $90.00 | $90.00 |