| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $457.73 | $457.73 | $457.73 | |
Cigna
| Professional | $457.73 | $457.73 | $457.73 | |
Medica
| Facility | $518.17 | $518.17 | $1,313.95 | |
Medica
| Professional | $518.17 | $518.17 | $518.17 | |
United
| Professional | $518.17 | $518.17 | $518.17 |