| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $114.24 | $114.24 | $114.24 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Puraply, puraply antimic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $114.24 | $114.24 | $114.24 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |