| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $87.31 | $149.18 | $200.29 |
Aetna
| Professional | 26 | $78.83 | $100.00 | $125.00 |
Ambetter
| Professional | 26 | $101.36 | $136.44 | $136.44 |
Cigna
| Professional | 26 | $77.95 | $95.01 | $149.91 |
Medica
| Facility | 26 | $207.94 | $207.94 | $207.94 |
Medica
| Professional | 26 | $84.15 | $100.56 | $554.45 |
United
| Professional | 26 | $74.45 | $93.59 | $159.65 |