| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.90 | $185.20 | $444.48 | |
Aetna
| Professional | $137.05 | $137.05 | $198.16 | |
Cigna
| Facility | $120.38 | $120.38 | $494.76 | |
Cigna
| Professional | $225.89 | $225.89 | $270.64 | |
Medica
| Facility | $137.05 | $185.20 | $311.14 | |
Medica
| Professional | $77.78 | $77.78 | $277.80 | |
United
| Professional | $77.78 | $77.78 | $118.53 |