| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.82 | $161.82 | $161.82 | |
Aetna
| Professional | $161.81 | $161.82 | $164.81 | |
Cigna
| Facility | $164.66 | $164.66 | $164.66 | |
Cigna
| Professional | $114.80 | $164.66 | $164.66 | |
Medica
| Facility | $140.79 | $167.46 | $623.78 | |
Medica
| Professional | $139.66 | $173.48 | $176.42 | |
United
| Professional | $139.66 | $169.22 | $176.42 |