| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $120.23 | $120.23 | |
Aetna
| Professional | $100.00 | $123.03 | $257.04 | |
Ambetter
| Professional | $56.23 | $75.86 | $141.25 | |
Cigna
| Professional | $9.77 | $9.77 | $9.77 | |
Medica
| Facility | $102.33 | $123.03 | $177.83 | |
United
| Professional | $218.78 | $218.78 | $275.42 |