| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.00 | $234.00 | $234.00 | |
Aetna
| Professional | $194.22 | $194.22 | $234.00 | |
Cigna
| Professional | $212.63 | $212.63 | $265.77 | |
Medica
| Facility | $203.58 | $234.00 | $234.00 | |
Medica
| Professional | $234.00 | $234.00 | $254.14 | |
United
| Professional | $198.90 | $234.00 | $254.14 |