| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $141.25 | $141.25 | $177.83 | |
Priority Health
| Professional | $141.25 | $141.25 | $141.25 | |
United
| Facility | $141.25 | $141.25 | $169.82 | |
United
| Professional | $69.18 | $95.50 | $158.49 |