| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $97.72 | $114.82 | $181.97 | |
Cigna
| Professional | $60.26 | $107.15 | $147.91 | |
Medica
| Professional | $181.97 | $181.97 | $181.97 | |
Molina
| Professional | $50.12 | $58.88 | $70.79 | |
Quartz
| Facility | $74.13 | $89.13 | $89.13 | |
Quartz
| Professional | $74.13 | $181.97 | $181.97 | |
United
| Professional | $34.67 | $34.67 | $64.57 |