| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $138.04 | $177.83 | $288.40 | |
Medica
| Facility | $138.04 | $138.04 | $138.04 | |
Medica
| Professional | $218.78 | $354.81 | $354.81 | |
United
| Facility | $11.75 | $11.75 | $11.75 | |
United
| Professional | $13.18 | $30.90 | $57.54 |