| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.43 | $52.43 | $8,500.00 | |
Aetna
| Professional | $52.43 | $74.34 | $75.30 | |
Cigna
| Professional | $99.22 | $99.22 | $99.22 | |
Medica
| Facility | $44.57 | $63.19 | $126.63 | |
Medica
| Professional | $79.76 | $146.47 | $550.08 | |
United
| Professional | $79.76 | $133.56 | $175.47 |