| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $18.89 | $18.89 | $18.89 | |
CareSource
| Professional | $55,999.44 | $59,999.40 | $75,599.24 | |
Cigna
| Professional | $48.00 | $48.00 | $48.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |