| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $263.77 | $404.90 | $896.90 | |
Medica
| Facility | $251.35 | $251.35 | $417.24 |
Rp Therapy Unlisted Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $263.77 | $404.90 | $896.90 | |
Medica
| Facility | $251.35 | $251.35 | $417.24 |