| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.61 | $25.61 | $32.01 | |
Medcost
| Facility | $11.20 | $24.44 | $31.86 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.61 | $25.61 | $32.01 | |
Medcost
| Facility | $11.20 | $24.44 | $31.86 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |