| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $3,467.37 | $3,467.37 | $3,467.37 | |
Medica
| Facility | $831.76 | $26,302.68 | $26,302.68 | |
Medica
| Professional | $3,630.78 | $9,332.54 | $9,332.54 |
Thrmbc Prq Arven Fstl Autog/Nonautog Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $3,467.37 | $3,467.37 | $3,467.37 | |
Medica
| Facility | $831.76 | $26,302.68 | $26,302.68 | |
Medica
| Professional | $3,630.78 | $9,332.54 | $9,332.54 |