| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.63 | $129.63 | $333.36 | |
Aetna
| Professional | $100.00 | $185.20 | $800.00 | |
Cigna
| Professional | $213.11 | $213.11 | $312.85 | |
Medica
| Facility | $100.00 | $140.75 | $360.14 | |
Medica
| Professional | $94.45 | $222.24 | $370.40 | |
United
| Professional | $77.78 | $188.90 | $314.83 |