| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $195.42 | $195.42 | $245.73 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Iv Us Non-C Vsl Dx Eval&/Ther Ivntj 1St Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $195.42 | $195.42 | $245.73 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |