| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $125.89 | $125.89 | $125.89 | |
Medica
| Facility | $190.55 | $346.74 | $346.74 | |
Medica
| Professional | $630.96 | $630.96 | $630.96 | |
United
| Facility | $1,174.90 | $1,905.46 | $2,951.21 | |
United
| Professional | $35.48 | $70.79 | $87.10 |