| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $230.69 | $269.58 | $413.54 | |
Cigna
| Professional | $162.87 | $247.84 | $292.76 | |
Medica
| Professional | $459.01 | $459.01 | $459.01 | |
Molina
| Professional | $50.00 | $58.40 | $70.00 | |
Quartz
| Facility | $348.00 | $348.00 | $348.00 | |
Quartz
| Professional | $303.54 | $459.01 | $459.01 |