| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $468.63 | $468.63 | $468.63 | |
Aetna
| Professional | $468.63 | $535.57 | $571.72 | |
Cigna
| Facility | $875.29 | $875.29 | $875.29 | |
Cigna
| Professional | $638.96 | $875.29 | $875.29 | |
Medica
| Facility | $349.02 | $655.99 | $5,634.02 | |
Medica
| Professional | $360.42 | $714.41 | $1,105.66 | |
United
| Professional | $360.42 | $522.14 | $814.38 |