| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $391.80 | $391.80 | $552.40 | |
Aetna
| Professional | $386.96 | $396.63 | $483.70 | |
Cigna
| Facility | $411.15 | $411.15 | $411.15 | |
Cigna
| Professional | $411.15 | $411.15 | $411.15 | |
Medica
| Facility | $391.80 | $414.83 | $553.44 | |
Medica
| Professional | $403.08 | $427.26 | $624.77 | |
United
| Professional | $403.08 | $403.08 | $494.18 |