| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.24 | $141.24 | $317.79 | |
Aetna
| Professional | $141.24 | $176.55 | $176.55 | |
Cigna
| Professional | $155.25 | $155.25 | $194.06 | |
Medica
| Facility | $141.24 | $176.55 | $240.11 | |
Medica
| Professional | $136.80 | $136.80 | $148.57 | |
United
| Professional | $116.28 | $136.80 | $150.47 |