| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $67.73 | $67.73 | $67.73 | |
Medica
| Facility | $57.64 | $105.77 | $293.31 | |
Medica
| Professional | $803.55 | $803.55 | $803.55 |
Medic-Physical Medic-Rehabilit
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $67.73 | $67.73 | $67.73 | |
Medica
| Facility | $57.64 | $105.77 | $293.31 | |
Medica
| Professional | $803.55 | $803.55 | $803.55 |