| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $750.00 | $750.00 | $862.50 | |
Cigna
| Professional | $750.00 | $750.00 | $937.50 | |
Medica
| Professional | $775.93 | $1,375.43 | $1,656.24 | |
United
| Professional | $840.54 | $1,402.50 | $1,656.24 |