| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
Cigna
| Professional | $371.73 | $371.73 | $371.73 | |
Medica
| Facility | $405.00 | $495.00 | $2,384.42 | |
Medica
| Professional | $372.15 | $487.77 | $683.17 | |
United
| Professional | $372.15 | $510.99 | $833.99 |