| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $182.03 | $212.71 | $326.31 | |
Cigna
| Professional | $128.51 | $192.65 | $231.01 | |
Medica
| Professional | $500.00 | $500.00 | $500.00 | |
Molina
| Professional | $50.00 | $58.40 | $70.00 | |
Quartz
| Facility | $341.79 | $341.79 | $341.79 | |
Quartz
| Professional | $239.63 | $500.00 | $500.00 |