| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.88 | $97.72 | $100.00 | |
Aetna
| Professional | $23.44 | $97.72 | $97.72 | |
Cigna
| Professional | $100.00 | $100.00 | $125.89 | |
Medica
| Facility | $36.31 | $36.31 | $165.96 | |
Medica
| Professional | $85.11 | $107.15 | $107.15 | |
United
| Professional | $97.72 | $107.15 | $107.15 |