| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.92 | $91.92 | $91.92 | |
Aetna
| Professional | $91.92 | $91.92 | $91.92 | |
Cigna
| Facility | $1,073.58 | $1,073.58 | $1,073.58 | |
Medica
| Facility | $61.97 | $96.52 | $349.35 | |
Medica
| Professional | $50.20 | $182.43 | $285.73 | |
United
| Professional | $49.21 | $175.83 | $241.77 |