| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $405.00 | $405.00 | $415.00 | |
Cigna
| Facility | $432.81 | $432.81 | $432.81 | |
Cigna
| Professional | $432.81 | $432.81 | $432.81 | |
Medica
| Facility | $405.00 | $579.15 | $2,785.98 | |
Medica
| Professional | $500.00 | $500.00 | $1,085.00 | |
United
| Professional | $500.00 | $500.00 | $500.00 |