| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $37.17 | $37.17 | $46.46 | |
Medcost
| Facility | $16.28 | $35.54 | $46.33 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $37.17 | $37.17 | $46.46 | |
Medcost
| Facility | $16.28 | $35.54 | $46.33 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |