| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $183.55 | $183.55 | $183.55 | |
Aetna
| Professional | $183.55 | $183.55 | $186.95 | |
Cigna
| Facility | $186.76 | $186.76 | $186.76 | |
Cigna
| Professional | $114.98 | $186.76 | $186.76 | |
Medica
| Facility | $153.35 | $192.73 | $707.51 | |
Medica
| Professional | $158.41 | $196.77 | $200.10 | |
United
| Professional | $158.41 | $196.77 | $200.10 |