| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $181.97 | $263.03 | $371.54 | |
Medica
| Facility | $275.42 | $275.42 | $371.54 | |
Medica
| Professional | $562.34 | $776.25 | $776.25 | |
United
| Professional | $69.18 | $104.71 | $199.53 |