| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $196.00 | $196.00 | $504.00 | |
Aetna
| Professional | $196.00 | $263.20 | $263.20 | |
Cigna
| Professional | $321.73 | $321.73 | $472.31 | |
Medica
| Facility | $70.45 | $201.60 | $504.00 | |
Medica
| Professional | $142.80 | $336.00 | $560.00 | |
United
| Professional | $117.60 | $285.60 | $476.00 |