| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $460.48 | $460.48 | $575.60 | |
Aetna
| Professional | $460.48 | $460.48 | $575.60 | |
Cigna
| Professional | $508.43 | $527.62 | $662.97 | |
Medica
| Facility | $460.48 | $498.26 | $575.60 | |
Medica
| Professional | $575.60 | $640.76 | $717.65 | |
United
| Professional | $575.60 | $575.60 | $717.65 |