| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.42 | $234.42 | $234.42 | |
Aetna
| Professional | $199.53 | $199.53 | $323.59 | |
Cigna
| Professional | $213.80 | $213.80 | $263.03 | |
Medica
| Facility | $234.42 | $234.42 | $234.42 | |
Medica
| Professional | $234.42 | $234.42 | $257.04 | |
United
| Professional | $199.53 | $234.42 | $263.03 |