| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $63.03 | $63.03 | $75.51 | |
Medica
| Facility | $52.06 | $88.57 | $179.38 | |
Medica
| Professional | $350.74 | $350.74 | $350.74 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $63.03 | $63.03 | $75.51 | |
Medica
| Facility | $52.06 | $88.57 | $179.38 | |
Medica
| Professional | $350.74 | $350.74 | $350.74 |