| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $644.60 | $644.60 | $644.60 | |
Aetna
| Professional | $644.60 | $736.69 | $743.64 | |
Cigna
| Facility | $967.10 | $967.10 | $967.10 | |
Cigna
| Professional | $705.98 | $967.10 | $967.10 | |
Medica
| Facility | $451.45 | $902.31 | $6,958.79 | |
Medica
| Professional | $444.00 | $880.07 | $1,520.86 | |
United
| Professional | $444.00 | $716.09 | $1,003.23 |