| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.86 | $114.82 | $194.98 | |
Aetna
| Professional | $75.86 | $107.15 | $213.80 | |
Cigna
| Professional | $93.33 | $257.04 | $407.38 | |
Medica
| Facility | $75.86 | $162.18 | $199.53 | |
Medica
| Professional | $660.69 | $660.69 | $660.69 | |
United
| Professional | $104.71 | $123.03 | $162.18 |