| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.86 | $75.86 | $8,500.00 | |
Aetna
| Professional | $75.86 | $106.93 | $106.93 | |
Cigna
| Professional | $103.88 | $129.84 | $163.13 | |
Medica
| Facility | $75.86 | $128.96 | $227.58 | |
Medica
| Professional | $123.76 | $203.20 | $244.45 | |
United
| Professional | $124.18 | $207.78 | $296.14 |