| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.78 | $74.78 | $74.78 | |
Aetna
| Professional | $74.78 | $84.42 | $91.92 | |
Cigna
| Facility | $299.64 | $441.66 | $988.59 | |
Medica
| Facility | $74.78 | $84.42 | $133.00 | |
Medica
| Professional | $59.08 | $219.79 | $316.31 | |
United
| Professional | $57.20 | $219.79 | $274.74 |