| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $208.10 | $208.10 | $223.82 | |
Aetna
| Professional | $166.12 | $208.10 | $212.56 | |
Cigna
| Professional | $401.63 | $405.64 | $510.06 | |
Medica
| Facility | $112.62 | $208.10 | $1,166.45 | |
Medica
| Professional | $118.26 | $165.17 | $247.75 | |
United
| Professional | $87.74 | $191.85 | $247.75 |