| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $914.81 | $914.81 | $914.81 | |
Aetna
| Professional | $795.00 | $896.80 | $1,004.88 | |
Cigna
| Professional | $4,077.00 | $4,117.77 | $5,096.25 | |
Medica
| Facility | $100.00 | $914.81 | $3,391.44 | |
Medica
| Professional | $38.58 | $71.48 | $159.41 | |
United
| Professional | $38.58 | $77.16 | $363.50 |