| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $9.16 | $9.16 | $9.16 | |
Cigna
| Professional | $9.16 | $9.16 | $9.16 | |
Medica
| Facility | $10.36 | $10.36 | $139.19 | |
Medica
| Professional | $10.36 | $10.36 | $10.36 | |
United
| Professional | $10.36 | $10.36 | $10.36 |