| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $677.33 | $677.33 | $677.33 | |
Medcost
| Facility | $677.33 | $677.33 | $1,469.01 | |
Medcost
| Professional | $677.33 | $677.33 | $677.33 |
Corplex P Per Cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $677.33 | $677.33 | $677.33 | |
Medcost
| Facility | $677.33 | $677.33 | $1,469.01 | |
Medcost
| Professional | $677.33 | $677.33 | $677.33 |