| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $687.60 | $687.60 | $687.60 | |
Aetna
| Professional | $687.60 | $761.56 | $995.06 | |
Cigna
| Professional | $71.76 | $71.76 | $5,096.25 | |
Medica
| Facility | $95.58 | $267.83 | $902.48 | |
Medica
| Professional | $40.57 | $64.91 | $199.28 | |
United
| Professional | $40.57 | $60.85 | $199.28 |