| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $0.02 | $0.02 | $38.02 | |
Molina
| Professional | $50.12 | $50.12 | $60.26 | |
SummaCare
| Professional | $60.26 | $60.26 | $60.26 |
Unspecified Diagnostic Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Professional | $0.02 | $0.02 | $38.02 | |
Molina
| Professional | $50.12 | $50.12 | $60.26 | |
SummaCare
| Professional | $60.26 | $60.26 | $60.26 |