| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $32.21 | $32.21 | $40.27 | |
Medcost
| Facility | $14.10 | $30.79 | $40.15 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $32.21 | $32.21 | $40.27 | |
Medcost
| Facility | $14.10 | $30.79 | $40.15 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |