| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $441.80 | $441.80 | $441.80 | |
Aetna
| Professional | $143.10 | $324.30 | $441.80 | |
Cigna
| Professional | $66.81 | $66.81 | $698.44 | |
Medica
| Facility | $28.10 | $232.75 | $441.80 | |
Medica
| Professional | $15.45 | $23.17 | $32.08 | |
United
| Professional | $15.45 | $23.17 | $32.08 |