| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.66 | $76.98 | $95.72 | |
Aetna
| Professional | $30.10 | $64.16 | $77.81 | |
Cigna
| Facility | $77.86 | $117.62 | $241.75 | |
Cigna
| Professional | $53.01 | $97.57 | $391.70 | |
Medica
| Facility | $80.11 | $107.35 | $163.91 | |
Medica
| Professional | $620.54 | $620.54 | $620.54 |