| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $142.40 | $270.57 | $1,702.90 | |
Aetna
| Professional | $101.72 | $109.85 | $270.57 | |
Cigna
| Facility | $95.96 | $95.96 | $101.72 | |
Cigna
| Professional | $101.72 | $101.72 | $101.72 | |
Medica
| Facility | $102.73 | $149.46 | $246.96 | |
Medica
| Professional | $100.72 | $100.72 | $515.16 | |
United
| Professional | $101.72 | $101.72 | $147.49 |