| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $59.20 | $59.20 | $59.20 | |
MVP Health Care
| Facility | $59.20 | $59.20 | $59.20 | |
MVP Health Care
| Professional | $3.30 | $3.30 | $3.30 |
Unlisted In Vivo Labortory Service
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $59.20 | $59.20 | $59.20 | |
MVP Health Care
| Facility | $59.20 | $59.20 | $59.20 | |
MVP Health Care
| Professional | $3.30 | $3.30 | $3.30 |