| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $751.56 | $751.56 | $751.56 | |
Aetna
| Professional | $717.57 | $717.57 | $751.56 | |
Cigna
| Professional | $477.77 | $477.77 | $477.77 | |
Medica
| Facility | $1,212.69 | $1,270.14 | $1,505.67 |