| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,631.77 | $1,631.77 | $1,631.77 | |
Cigna
| Professional | $481.50 | $510.39 | $611.51 | |
Medica
| Facility | $906.54 | $906.54 | $906.54 | |
Medica
| Professional | $177.30 | $224.52 | $359.92 | |
United
| Professional | $149.68 | $187.10 | $354.60 |