| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.07 | $66.07 | $67.61 | |
Aetna
| Professional | $63.10 | $70.79 | $158.49 | |
Cigna
| Professional | $61.66 | $61.66 | $75.86 | |
Medica
| Facility | $66.07 | $66.07 | $199.53 | |
Medica
| Professional | $63.10 | $70.79 | $75.86 | |
United
| Professional | $64.57 | $70.79 | $79.43 |