| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $808.25 | $808.25 | $808.25 | |
Medica
| Facility | $1,032.33 | $1,803.13 | $4,966.62 | |
Medica
| Professional | $755.86 | $889.25 | $898.14 | |
United
| Professional | $755.86 | $889.25 | $898.14 |