| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,047.13 | $1,047.13 | $1,047.13 | |
Cigna
| Professional | $891.25 | $891.25 | $1,047.13 | |
Medica
| Facility | $100.00 | $100.00 | $630.96 | |
Medica
| Professional | $588.84 | $588.84 | $588.84 |