| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $165.52 | $165.52 | $165.52 | |
Medica
| Facility | $218.06 | $677.49 | $677.49 | |
Medica
| Professional | $66.69 | $710.30 | $710.30 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $165.52 | $165.52 | $165.52 | |
Medica
| Facility | $218.06 | $677.49 | $677.49 | |
Medica
| Professional | $66.69 | $710.30 | $710.30 |