| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $207.76 | $207.76 | $207.76 | |
Aetna
| Professional | $101.50 | $153.77 | $207.76 | |
Cigna
| Professional | $141.06 | $141.06 | $141.06 | |
Medica
| Facility | $144.50 | $207.76 | $261.22 | |
Medica
| Professional | $150.13 | $197.05 | $1,105.55 | |
United
| Professional | $150.13 | $197.05 | $260.30 |