| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $195.00 | $195.00 | $243.75 | |
Medica
| Professional | $616.66 | $616.66 | $616.66 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $195.00 | $195.00 | $243.75 | |
Medica
| Professional | $616.66 | $616.66 | $616.66 |