| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $134.90 | $245.47 | |
Aetna
| Professional | $102.33 | $134.90 | $223.87 | |
Cigna
| Professional | $134.90 | $134.90 | $169.82 | |
Medica
| Facility | $134.90 | $134.90 | $229.09 | |
Medica
| Professional | $117.49 | $128.82 | $141.25 | |
United
| Professional | $117.49 | $128.82 | $147.91 |