| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.90 | $269.15 | $389.05 | |
Aetna
| Professional | $134.90 | $134.90 | $229.09 | |
Cigna
| Professional | $144.54 | $144.54 | $144.54 | |
Medica
| Facility | $169.82 | $257.04 | $630.96 | |
Medica
| Professional | $141.25 | $141.25 | $169.82 | |
United
| Professional | $134.90 | $141.25 | $169.82 |