| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $56.38 | $70.90 | $118.68 | |
Medica
| Facility | $49.00 | $62.37 | $1,791.30 | |
Medica
| Professional | $237.00 | $237.00 | $237.00 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $56.38 | $70.90 | $118.68 | |
Medica
| Facility | $49.00 | $62.37 | $1,791.30 | |
Medica
| Professional | $237.00 | $237.00 | $237.00 |