| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $157.37 | $157.37 | $157.37 | |
Aetna
| Professional | $155.47 | $157.37 | $157.37 | |
Cigna
| Professional | $164.86 | $164.86 | $164.86 | |
Medica
| Facility | $155.47 | $197.86 | $934.12 | |
Medica
| Professional | $165.14 | $216.60 | $278.62 | |
United
| Professional | $165.14 | $226.36 | $277.33 |