| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.01 | $106.01 | $106.01 | |
Aetna
| Professional | $106.01 | $106.01 | $107.97 | |
Cigna
| Facility | $96.58 | $96.58 | $96.58 | |
Cigna
| Professional | $96.58 | $96.58 | $96.58 | |
Medica
| Facility | $59.53 | $87.88 | $150.50 | |
Medica
| Professional | $69.69 | $86.56 | $94.85 | |
United
| Professional | $81.92 | $101.75 | $103.48 |