| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $308.00 | $308.00 | $792.00 | |
Aetna
| Professional | $308.00 | $413.60 | $413.60 | |
Cigna
| Professional | $505.51 | $505.51 | $742.11 | |
Medica
| Facility | $159.03 | $316.80 | $792.00 | |
Medica
| Professional | $90.62 | $222.10 | $880.00 | |
United
| Professional | $90.62 | $211.00 | $748.00 |