| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $83.50 | $120.00 | $190.89 |
Aetna
| Professional | 26 | $75.39 | $100.00 | $125.00 |
Cigna
| Professional | 26 | $76.26 | $102.50 | $159.38 |
Medica
| Facility | 26 | $197.95 | $197.95 | $197.95 |
Medica
| Professional | 26 | $81.96 | $105.42 | $2,660.92 |
United
| Professional | 26 | $81.96 | $89.61 | $182.64 |