| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $49.69 | $72.50 | $169.53 | |
Cigna
| Professional | $22.35 | $25.96 | $28.10 | |
Health Partners
| Facility | $39.13 | $67.26 | $133.49 | |
Health Partners
| Professional | $22.13 | $22.13 | $30.09 | |
Medica
| Facility | $90.00 | $90.00 | $90.00 |