| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $457.70 | $973.30 | $1,232.50 | |
Medica
| Facility | $4,137.00 | $26,542.00 | $26,542.00 | |
Medica
| Professional | $1,525.77 | $1,525.77 | $1,525.77 | |
United
| Professional | $239.28 | $336.54 | $564.92 |