| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $59.46 | $74.04 | $75.51 | |
Medica
| Facility | $57.95 | $85.22 | $279.63 | |
Medica
| Professional | $350.74 | $350.74 | $350.74 |
Ffs - Not Available
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $59.46 | $74.04 | $75.51 | |
Medica
| Facility | $57.95 | $85.22 | $279.63 | |
Medica
| Professional | $350.74 | $350.74 | $350.74 |