| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.55 | $257.04 | $489.78 | |
Aetna
| Professional | $173.78 | $208.93 | $331.13 | |
Cigna
| Professional | $316.23 | $316.23 | $398.11 | |
Medica
| Facility | $165.96 | $208.93 | $489.78 | |
Medica
| Professional | $114.82 | $323.59 | $549.54 | |
United
| Professional | $114.82 | $281.84 | $467.74 |