| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $154.47 | $154.47 | $154.47 | |
Aetna
| Professional | $154.47 | $176.55 | $178.23 | |
Cigna
| Facility | $231.66 | $231.66 | $231.66 | |
Cigna
| Professional | $169.11 | $231.66 | $231.66 | |
Medica
| Facility | $103.04 | $216.24 | $1,667.62 | |
Medica
| Professional | $106.40 | $210.90 | $364.48 | |
United
| Professional | $106.40 | $171.61 | $240.42 |