| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.82 | $120.82 | $8,500.00 | |
Aetna
| Professional | $110.33 | $169.67 | $202.94 | |
Cigna
| Professional | $211.88 | $213.99 | $269.08 | |
Medica
| Facility | $120.82 | $169.74 | $328.97 | |
Medica
| Professional | $174.31 | $292.35 | $489.98 | |
United
| Professional | $187.97 | $292.35 | $413.53 |