| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $107.15 | $194.98 | $288.40 | |
Cigna
| Professional | $79.43 | $85.11 | $102.33 | |
Molina
| Professional | $64.57 | $64.57 | $64.57 | |
Quartz
| Professional | $75.86 | $75.86 | $134.90 | |
Quartz
| Facility | $302.00 | $398.11 | $398.11 |