| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $210.95 | $210.95 | $542.42 | |
Aetna
| Professional | $210.95 | $283.27 | $283.27 | |
Cigna
| Professional | $346.51 | $346.51 | $508.69 | |
Medica
| Facility | $180.81 | $229.03 | $542.42 | |
Medica
| Professional | $153.69 | $361.62 | $602.70 | |
United
| Professional | $126.57 | $307.38 | $512.29 |