| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $30.98 | $30.98 | $38.72 | |
Medcost
| Facility | $13.61 | $29.70 | $38.72 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $30.98 | $30.98 | $38.72 | |
Medcost
| Facility | $13.61 | $29.70 | $38.72 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |