| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $87.13 | $99.01 | $143.66 | |
Medica
| Facility | $90.00 | $90.00 | $630.00 | |
Medica
| Professional | $204.00 | $258.39 | $258.39 | |
Molina
| Professional | $58.40 | $58.40 | $58.40 | |
Quartz
| Facility | $70.00 | $70.00 | $630.00 | |
Quartz
| Professional | $61.87 | $204.00 | $258.39 |