| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.11 | $83.11 | $83.11 | |
Aetna
| Professional | $36.54 | $83.11 | $105.30 | |
Cigna
| Facility | $347.93 | $347.93 | $347.93 | |
Cigna
| Professional | $141.80 | $141.80 | $141.80 | |
Medica
| Facility | $44.62 | $83.11 | $105.30 | |
Medica
| Professional | $42.95 | $62.11 | $564.65 | |
United
| Professional | $42.95 | $53.06 | $96.66 |