| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.26 | $27.26 | $34.07 | |
Medcost
| Facility | $11.83 | $25.83 | $33.67 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $27.26 | $27.26 | $34.07 | |
Medcost
| Facility | $11.83 | $25.83 | $33.67 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |