| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $178.76 | $178.76 | $178.76 | |
Aetna
| Professional | $143.10 | $159.22 | $194.48 | |
Cigna
| Professional | $125.04 | $257.55 | $318.75 | |
Medica
| Facility | $39.02 | $178.76 | $365.02 | |
Medica
| Professional | $10.22 | $19.29 | $38.58 | |
United
| Professional | $7.86 | $21.03 | $81.62 |