| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.75 | $91.66 | $219.98 | |
Aetna
| Professional | $67.83 | $67.83 | $98.08 | |
Cigna
| Facility | $59.58 | $59.58 | $244.87 | |
Cigna
| Professional | $111.63 | $111.63 | $133.75 | |
Medica
| Facility | $67.83 | $91.66 | $153.99 | |
Medica
| Professional | $38.50 | $47.53 | $137.49 | |
United
| Professional | $38.50 | $47.53 | $67.90 |