| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $36.11 | $54.00 | $74.70 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $36.11 | $54.00 | $74.70 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |