| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $107.38 | $196.44 | $278.43 | |
Cigna
| Professional | $77.51 | $84.20 | $102.19 | |
Molina
| Professional | $65.00 | $65.00 | $65.00 | |
Quartz
| Professional | $75.51 | $75.51 | $133.44 | |
Quartz
| Facility | $393.60 | $393.60 | $393.60 |