| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $236.53 | $236.53 | $268.79 | |
Medica
| Facility | $344.23 | $344.23 | $407.44 | |
Medica
| Professional | $796.67 | $796.67 | $796.67 | |
Molina
| Professional | $50.00 | $58.40 | $70.00 | |
Quartz
| Facility | $258.89 | $344.23 | $407.44 | |
Quartz
| Professional | $325.87 | $392.86 | $796.67 |