| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $502.51 | $502.51 | $502.51 | |
Medcost
| Facility | $441.51 | $554.44 | $773.45 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Cltx Pel Ring Fx Dislc Diast/Sublxtj W/O Manj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $502.51 | $502.51 | $502.51 | |
Medcost
| Facility | $441.51 | $554.44 | $773.45 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |