| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $247.19 | $247.19 | $247.19 | |
Aetna
| Professional | $247.19 | $282.50 | $282.50 | |
Cigna
| Facility | $340.42 | $340.42 | $340.42 | |
Cigna
| Professional | $248.51 | $340.42 | $340.42 | |
Medica
| Facility | $161.69 | $346.03 | $2,588.55 | |
Medica
| Professional | $166.97 | $330.96 | $583.22 | |
United
| Professional | $166.97 | $267.14 | $377.28 |