| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.90 | $95.90 | $246.60 | |
Aetna
| Professional | $45.00 | $95.90 | $128.78 | |
Cigna
| Professional | $157.77 | $157.77 | $231.61 | |
Medica
| Facility | $65.00 | $98.64 | $246.60 | |
Medica
| Professional | $69.87 | $164.40 | $274.00 | |
United
| Professional | $57.54 | $143.85 | $232.90 |