| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.56 | $168.75 | $405.00 | |
Aetna
| Professional | $124.88 | $124.88 | $180.56 | |
Cigna
| Facility | $83.30 | $109.69 | $450.83 | |
Cigna
| Professional | $75.22 | $205.76 | $246.52 | |
Medica
| Facility | $124.88 | $168.75 | $283.50 | |
Medica
| Professional | $70.88 | $70.88 | $253.13 | |
United
| Professional | $70.88 | $70.88 | $108.00 |