| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $191.76 | $191.76 | $191.76 | |
Aetna
| Professional | $191.75 | $191.76 | $195.31 | |
Cigna
| Facility | $174.44 | $174.44 | $174.44 | |
Cigna
| Professional | $174.44 | $174.44 | $174.44 | |
Medica
| Facility | $110.17 | $182.59 | $274.22 | |
Medica
| Professional | $147.96 | $176.00 | $186.90 | |
United
| Professional | $147.96 | $183.79 | $186.90 |