| 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 | $19.50 | $19.50 | $19.50 | |
Cigna
| Professional | $38.02 | $38.02 | $47.86 | |
United
| Professional | $38.90 | $38.90 | $38.90 |