| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.08 | $276.74 | $825.00 | |
Aetna
| Professional | $102.14 | $102.14 | $121.70 | |
Ambetter
| Professional | $125.00 | $125.00 | $125.00 | |
Cigna
| Professional | $119.90 | $119.90 | $119.90 | |
Medica
| Facility | $100.00 | $117.46 | $163.41 |