| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.63 | $72.63 | $108.95 | |
Aetna
| Professional | $72.63 | $72.63 | $72.63 | |
Cigna
| Facility | $459.14 | $459.14 | $459.14 | |
Medica
| Facility | $47.84 | $76.26 | $302.85 | |
Medica
| Professional | $76.22 | $95.28 | $132.63 | |
United
| Professional | $71.45 | $97.36 | $126.72 |