| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $22.13 | $22.13 | $27.66 | |
Medcost
| Professional | $22.16 | $22.16 | $22.16 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Gold
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $22.13 | $22.13 | $27.66 | |
Medcost
| Professional | $22.16 | $22.16 | $22.16 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |