| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.24 | $163.24 | $163.24 | |
Aetna
| Professional | $163.24 | $163.24 | $163.24 | |
Cigna
| Professional | $160.50 | $162.11 | $200.63 | |
Medica
| Facility | $157.69 | $163.24 | $489.72 | |
Medica
| Professional | $179.18 | $181.48 | $192.05 | |
United
| Professional | $164.98 | $181.48 | $186.43 |