| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $176.30 | $176.30 | $176.30 | |
Aetna
| Professional | $176.30 | $176.30 | $179.56 | |
Cigna
| Facility | $179.39 | $179.39 | $179.39 | |
Cigna
| Professional | $145.90 | $179.39 | $179.39 | |
Medica
| Facility | $158.66 | $192.05 | $492.01 | |
Medica
| Professional | $156.72 | $192.05 | $197.98 | |
United
| Professional | $156.72 | $192.05 | $197.98 |