| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $231.99 | $231.99 | $231.99 | |
Aetna
| Professional | $118.46 | $170.29 | $231.99 | |
Cigna
| Facility | $147.10 | $147.10 | $147.10 | |
Cigna
| Professional | $107.38 | $125.04 | $255.00 | |
Medica
| Facility | $28.77 | $145.86 | $408.54 | |
Medica
| Professional | $7.86 | $14.40 | $32.08 | |
United
| Professional | $8.17 | $13.24 | $32.08 |