| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $5,011.87 | $8,511.38 | $77,624.71 | |
Capital Blue Cross
| Professional | $14.13 | $14.13 | $14.13 | |
Cigna
| Professional | $15.85 | $15.85 | $19.50 | |
United
| Professional | $16.22 | $16.22 | $16.22 |