| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $66.58 | $103.92 | $249.98 | |
Cigna
| Professional | $29.25 | $31.01 | $37.15 | |
Health Partners
| Facility | $53.44 | $86.36 | $196.84 | |
Health Partners
| Professional | $29.25 | $29.25 | $34.79 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 |