| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $233.36 | $233.36 | $233.36 | |
Aetna
| Professional | $150.41 | $182.08 | $233.36 | |
Cigna
| Professional | $216.38 | $216.38 | $216.38 | |
Medica
| Facility | $233.36 | $318.20 | $469.67 | |
Medica
| Professional | $254.57 | $254.57 | $285.12 | |
United
| Professional | $254.57 | $254.57 | $285.12 |