| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.95 | $84.95 | $84.95 | |
Aetna
| Professional | $84.19 | $84.95 | $125.20 | |
Cigna
| Professional | $202.00 | $202.00 | $202.00 | |
Health Partners
| Professional | $198.14 | $198.14 | $198.14 | |
Medica
| Facility | $84.19 | $84.95 | $143.57 | |
Medica
| Professional | $451.00 | $451.00 | $451.00 | |
United
| Facility | $233.00 | $233.00 | $233.00 |