| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.60 | $61.60 | $61.60 | |
Aetna
| Professional | $39.79 | $64.27 | $70.48 | |
Cigna
| Professional | $90.23 | $90.23 | $165.04 | |
Medica
| Facility | $61.60 | $80.08 | $123.35 | |
Medica
| Professional | $78.50 | $131.35 | $432.44 | |
United
| Professional | $72.90 | $128.34 | $170.37 |