| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $149.31 | $149.31 | $383.94 | |
Aetna
| Professional | $149.31 | $200.50 | $200.50 | |
Cigna
| Professional | $244.91 | $244.91 | $359.54 | |
Medica
| Facility | $127.98 | $162.11 | $383.94 | |
Medica
| Professional | $77.80 | $190.68 | $426.60 | |
United
| Professional | $77.80 | $213.30 | $309.29 |