| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $227.49 | $425.22 | $637.83 | |
Aetna
| Professional | $172.21 | $172.21 | $206.65 | |
Cigna
| Facility | $180.30 | $180.30 | $180.30 | |
Medica
| Facility | $184.37 | $212.61 | $246.26 | |
Medica
| Professional | $180.30 | $180.30 | $180.30 | |
United
| Professional | $180.30 | $180.30 | $180.30 |