| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $145.00 | $145.00 | $171.86 | |
Aetna
| Professional | $116.00 | $116.00 | $145.00 | |
Cigna
| Facility | $79.00 | $79.00 | $91.00 | |
Medica
| Facility | $116.00 | $133.40 | $210.25 | |
Medica
| Professional | $319.00 | $319.00 | $319.00 |