| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $627.52 | $627.52 | $627.52 | |
Aetna
| Professional | $627.52 | $762.26 | $851.07 | |
Cigna
| Professional | $630.72 | $630.72 | $630.72 | |
Medica
| Facility | $627.52 | $762.87 | $1,111.98 | |
Medica
| Professional | $79.31 | $240.27 | $4,977.89 | |
United
| Professional | $77.30 | $211.64 | $497.69 |