| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
Medica
| Facility | $1,513.56 | $1,513.56 | $1,513.56 | |
United
| Facility | $1,513.56 | $1,513.56 | $1,513.56 |
Leave of Absence-Therapeutic Leave
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,862.09 | $1,862.09 | $1,862.09 | |
Medica
| Facility | $1,513.56 | $1,513.56 | $1,513.56 | |
United
| Facility | $1,513.56 | $1,513.56 | $1,513.56 |