| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $208.93 | $208.93 | $245.47 | |
Medica
| Facility | $257.04 | $257.04 | $309.03 | |
Medica
| Professional | $616.60 | $616.60 | $616.60 | |
United
| Professional | $74.13 | $74.13 | $104.71 |