| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.63 | $129.63 | $261.43 | |
Aetna
| Professional | $129.63 | $162.80 | $162.80 | |
Cigna
| Professional | $592.13 | $592.13 | $740.16 | |
Medica
| Facility | $129.63 | $217.86 | $645.89 | |
Medica
| Professional | $645.89 | $645.89 | $701.47 | |
United
| Professional | $549.01 | $645.89 | $852.57 |