| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $54.66 | $54.66 | $62.11 | |
Medica
| Facility | $330.90 | $330.90 | $330.90 | |
Medica
| Professional | $154.00 | $154.00 | $154.00 | |
Molina
| Professional | $50.00 | $65.00 | $70.00 | |
Quartz
| Facility | $215.72 | $330.90 | $330.90 | |
Quartz
| Professional | $24.09 | $154.00 | $154.00 |