| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $58.40 | $58.40 | $58.40 | |
Quartz
| Facility | $245.73 | $245.73 | $245.73 |
Medical
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $58.40 | $58.40 | $58.40 | |
Quartz
| Facility | $245.73 | $245.73 | $245.73 |