| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $627.41 | $1,168.83 | $1,562.72 | |
Aetna
| Professional | $185.47 | $314.18 | $348.57 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $52.02 | $52.02 | $52.02 | |
Medica
| Facility | $185.47 | $433.26 | $693.55 |