| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.45 | $66.45 | $8,500.00 | |
Aetna
| Professional | $60.92 | $93.84 | $120.00 | |
Cigna
| Professional | $115.50 | $116.66 | $146.69 | |
Medica
| Facility | $66.45 | $114.19 | $179.55 | |
Medica
| Professional | $98.49 | $165.49 | $268.77 | |
United
| Professional | $103.11 | $165.49 | $226.84 |