| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.22 | $75.30 | $80.73 | |
Aetna
| Professional | $66.43 | $69.20 | $69.22 | |
Cigna
| Professional | $78.83 | $78.83 | $98.53 | |
Medica
| Facility | $69.22 | $69.22 | $207.66 | |
Medica
| Professional | $81.43 | $85.10 | $85.10 | |
United
| Professional | $72.72 | $85.10 | $87.42 |