| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $107.14 | $168.57 | $402.27 | |
Cigna
| Professional | $58.40 | $73.43 | $92.31 | |
Health Partners
| Facility | $91.39 | $152.88 | $316.75 | |
Health Partners
| Professional | $57.82 | $57.82 | $91.39 | |
Medica
| Facility | $25.13 | $74.56 | $195.00 |