| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $158.66 | $171.91 | $199.21 | |
Ambetter
| Professional | $218.30 | $218.30 | $218.30 | |
Cigna
| Professional | $45.05 | $45.05 | $45.05 | |
Medica
| Facility | $158.66 | $166.60 | $202.10 | |
Medica
| Professional | $161.71 | $161.71 | $161.71 | |
United
| Professional | $161.71 | $161.71 | $161.71 |