| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $145.28 | $145.28 | $145.28 | |
Aetna
| Professional | $71.75 | $116.28 | $145.28 | |
Cigna
| Professional | $107.43 | $107.43 | $107.43 | |
Medica
| Facility | $101.39 | $145.28 | $197.40 | |
Medica
| Professional | $107.13 | $141.00 | $768.84 | |
United
| Professional | $107.11 | $138.32 | $180.75 |