| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.99 | $139.69 | $203.46 | |
Aetna
| Professional | $20.07 | $126.99 | $162.62 | |
Cigna
| Facility | $86.58 | $86.58 | $113.07 | |
Medica
| Facility | $41.28 | $126.99 | $296.60 | |
Medica
| Professional | $42.20 | $160.11 | $278.07 | |
United
| Professional | $128.96 | $161.03 | $212.33 |