| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.21 | $131.21 | $162.13 | |
Aetna
| Professional | $131.21 | $158.09 | $162.13 | |
Cigna
| Professional | $164.86 | $164.86 | $164.86 | |
Medica
| Facility | $172.62 | $347.11 | $934.12 | |
Medica
| Professional | $172.07 | $218.04 | $326.80 | |
United
| Professional | $172.07 | $218.04 | $326.80 |