| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $309.26 | $309.26 | $309.26 | |
Aetna
| Professional | $301.60 | $301.60 | $309.26 | |
Cigna
| Professional | $238.10 | $238.10 | $238.10 | |
Medica
| Facility | $294.77 | $324.72 | $1,577.08 | |
Medica
| Professional | $187.68 | $246.61 | $304.98 | |
United
| Professional | $187.68 | $246.61 | $303.70 |