| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.70 | $73.70 | $103.50 | |
Aetna
| Professional | $60.93 | $100.86 | $107.43 | |
Cigna
| Professional | $83.40 | $83.40 | $83.40 | |
Medica
| Facility | $41.08 | $73.70 | $112.92 | |
Medica
| Professional | $141.38 | $217.50 | $659.14 | |
United
| Professional | $23.29 | $144.51 | $220.78 |