| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $2,122.69 | $2,122.69 | $2,122.69 | |
Medica
| Facility | $55.00 | $55.00 | $4,664.43 | |
Medica
| Professional | $13,636.00 | $13,636.00 | $13,636.00 | |
United
| Facility | $1,367.00 | $1,880.00 | $3,030.00 |