| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.69 | $156.69 | $156.69 | |
Aetna
| Professional | $101.01 | $122.99 | $156.69 | |
Cigna
| Professional | $147.91 | $147.91 | $147.91 | |
Medica
| Facility | $156.69 | $266.39 | $632.59 | |
Medica
| Professional | $174.02 | $342.87 | $384.01 | |
United
| Professional | $291.44 | $342.87 | $342.87 |