| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $91.00 | $91.00 | $91.00 | |
Medcost
| Facility | $6.00 | $151.00 | $215.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Unlisted Psychiatric Service/Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $91.00 | $91.00 | $91.00 | |
Medcost
| Facility | $6.00 | $151.00 | $215.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |