| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.40 | $113.09 | $113.09 | |
Aetna
| Professional | $34.96 | $103.46 | $113.09 | |
Cigna
| Professional | $79.62 | $79.62 | $208.61 | |
Medica
| Facility | $49.50 | $113.09 | $205.44 | |
Medica
| Professional | $183.11 | $316.27 | $1,006.55 | |
United
| Professional | $43.32 | $299.63 | $420.60 |