| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $18.00 | $18.18 | $22.86 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 |
Drug confirmation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $18.00 | $18.18 | $22.86 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 |