| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.50 | $150.00 | $360.00 | |
Aetna
| Professional | $111.00 | $111.00 | $160.50 | |
Cigna
| Facility | $97.50 | $97.50 | $400.73 | |
Cigna
| Professional | $166.16 | $166.16 | $199.07 | |
Medica
| Facility | $111.00 | $141.44 | $252.00 | |
Medica
| Professional | $63.00 | $63.00 | $225.00 | |
United
| Professional | $63.00 | $63.00 | $96.00 |