| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $84.68 | $88.07 | $481.23 |
Aetna
| Professional | 26 | $100.00 | $118.75 | $200.00 |
Cigna
| Professional | 26 | $74.31 | $88.21 | $139.55 |
Medica
| Facility | 26 | $197.95 | $1,566.00 | $1,566.00 |
Medica
| Professional | 26 | $62.15 | $81.54 | $176.23 |
United
| Professional | 26 | $62.15 | $81.54 | $108.86 |