| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.93 | $91.93 | $8,500.00 | |
Aetna
| Professional | $91.93 | $91.93 | $121.85 | |
Cigna
| Professional | $28.13 | $28.13 | $35.15 | |
Medica
| Facility | $91.93 | $119.91 | $275.79 | |
Medica
| Professional | $145.97 | $267.01 | $400.44 | |
United
| Professional | $138.68 | $271.91 | $400.44 |