| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.99 | $112.99 | $112.99 | |
Aetna
| Professional | $79.12 | $94.12 | $112.99 | |
Cigna
| Facility | $112.34 | $112.34 | $112.34 | |
Cigna
| Professional | $27.00 | $34.29 | $76.88 | |
Medica
| Facility | $79.12 | $134.47 | $163.13 | |
Medica
| Professional | $75.22 | $135.40 | $603.54 | |
United
| Professional | $75.22 | $132.10 | $219.30 |