| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $134.90 | $181.97 | $436.52 | |
Cigna
| Professional | $38.90 | $95.50 | $204.17 | |
Health Partners
| Facility | $134.90 | $177.83 | $407.38 | |
Health Partners
| Professional | $38.90 | $87.10 | $190.55 | |
Medica
| Professional | $117.49 | $302.00 | $302.00 |