| 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 | $5,177.79 | |
Medica
| Facility | $97.53 | $914.81 | $1,182.72 | |
Medica
| Professional | $38.58 | $62.73 | $135.84 | |
United
| Professional | $35.76 | $60.85 | $135.84 |