| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.57 | $50.57 | $8,500.00 | |
Aetna
| Professional | $50.57 | $92.12 | $93.40 | |
Cigna
| Professional | $85.13 | $85.13 | $106.41 | |
Medica
| Facility | $50.57 | $69.83 | $151.71 | |
Medica
| Professional | $76.15 | $126.31 | $186.80 | |
United
| Professional | $75.97 | $125.55 | $186.80 |