| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $196.95 | $196.95 | $196.95 | |
Medica
| Facility | $255.48 | $255.48 | $306.57 | |
Medica
| Professional | $246.67 | $616.66 | $616.66 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $196.95 | $196.95 | $196.95 | |
Medica
| Facility | $255.48 | $255.48 | $306.57 | |
Medica
| Professional | $246.67 | $616.66 | $616.66 |