| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $262.68 | $262.68 | $675.45 | |
Aetna
| Professional | $262.68 | $352.74 | $352.74 | |
Cigna
| Professional | $431.17 | $431.17 | $632.98 | |
Medica
| Facility | $83.92 | $270.18 | $675.45 | |
Medica
| Professional | $47.81 | $157.61 | $750.50 | |
United
| Professional | $47.81 | $450.30 | $720.86 |