| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $231.70 | $231.70 | $595.79 | |
Aetna
| Professional | $231.70 | $311.14 | $311.14 | |
Cigna
| Professional | $380.37 | $380.37 | $558.41 | |
Medica
| Facility | $66.48 | $238.32 | $595.79 | |
Medica
| Professional | $132.84 | $325.60 | $662.00 | |
United
| Facility | $331.00 | $331.00 | $331.00 | |
United
| Professional | $132.84 | $337.62 | $562.70 |