| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.00 | $140.00 | $140.00 | |
Aetna
| Professional | $140.00 | $140.00 | $140.00 | |
Cigna
| Professional | $163.00 | $163.00 | $163.00 | |
Medica
| Facility | $140.00 | $140.00 | $238.00 | |
Medica
| Professional | $124.07 | $184.87 | $284.41 | |
United
| Professional | $113.76 | $184.87 | $298.63 |