| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.96 | $223.87 | $426.58 | |
Aetna
| Professional | $151.36 | $181.97 | $281.84 | |
Cigna
| Professional | $275.42 | $275.42 | $338.84 | |
Medica
| Facility | $141.25 | $169.82 | $426.58 | |
Medica
| Professional | $83.18 | $194.98 | $478.63 | |
United
| Professional | $83.18 | $204.17 | $407.38 |