| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.83 | $177.83 | $275.42 | |
Aetna
| Professional | $169.82 | $177.83 | $229.09 | |
Cigna
| Professional | $181.97 | $181.97 | $223.87 | |
Medica
| Facility | $169.82 | $177.83 | $537.03 | |
Medica
| Professional | $154.88 | $169.82 | $169.82 | |
United
| Professional | $154.88 | $169.82 | $199.53 |