| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $504.27 | $509.32 | $640.42 | |
Medica
| Facility | $1,755.72 | $1,755.72 | $1,755.72 | |
Medica
| Professional | $2,194.65 | $2,194.65 | $2,194.65 | |
United
| Professional | $184.35 | $184.35 | $252.88 |