| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $669.94 | $669.94 | $669.94 | |
Aetna
| Professional | $30.46 | $30.46 | $30.46 | |
Cigna
| Facility | $31.96 | $31.96 | $31.96 | |
Cigna
| Professional | $31.96 | $31.96 | $31.96 | |
Medica
| Facility | $30.83 | $39.29 | $138.08 | |
Medica
| Professional | $37.60 | $37.60 | $81.59 | |
United
| Professional | $37.60 | $37.60 | $37.60 |