| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $125.89 | $125.89 | $158.49 | |
Medica
| Facility | $165.96 | $165.96 | $208.93 | |
Medica
| Professional | $302.00 | $302.00 | $302.00 | |
United
| Facility | $114.82 | $114.82 | $138.04 | |
United
| Professional | $51.29 | $51.29 | $51.29 |