| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $353.50 | $353.50 | $353.50 | |
Aetna
| Professional | $211.19 | $296.10 | $353.50 | |
Cigna
| Professional | $558.75 | $564.34 | $698.44 | |
Medica
| Facility | $39.02 | $312.08 | $379.76 | |
Medica
| Professional | $19.29 | $21.03 | $38.58 | |
United
| Professional | $15.45 | $21.03 | $38.58 |