| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $263.51 | $360.17 | $521.63 | |
Medica
| Facility | $273.93 | $273.93 | $375.42 | |
Medica
| Professional | $567.32 | $777.00 | $777.00 |
Prolonged Svc Outpatient Setting 1st Hour
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $263.51 | $360.17 | $521.63 | |
Medica
| Facility | $273.93 | $273.93 | $375.42 | |
Medica
| Professional | $567.32 | $777.00 | $777.00 |