| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.37 | $24.37 | $30.46 | |
Medcost
| Facility | $13.36 | $13.87 | $13.87 | |
Medcost
| Professional | $13.36 | $33.90 | $38.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $24.37 | $24.37 | $30.46 | |
Medcost
| Facility | $13.36 | $13.87 | $13.87 | |
Medcost
| Professional | $13.36 | $33.90 | $38.00 |