| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.61 | $25.61 | $32.01 | |
Medcost
| Facility | $14.31 | $14.51 | $14.51 | |
Medcost
| Professional | $14.31 | $26.00 | $39.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.61 | $25.61 | $32.01 | |
Medcost
| Facility | $14.31 | $14.51 | $14.51 | |
Medcost
| Professional | $14.31 | $26.00 | $39.00 |