| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.25 | $107.00 | $256.80 | |
Aetna
| Professional | $79.18 | $79.18 | $80.25 | |
Cigna
| Facility | $69.55 | $69.55 | $93.89 | |
Cigna
| Professional | $130.46 | $130.46 | $156.30 | |
Medica
| Facility | $79.18 | $107.00 | $179.76 | |
Medica
| Professional | $44.94 | $44.94 | $160.50 | |
United
| Professional | $44.94 | $44.94 | $68.48 |