| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.89 | $71.89 | $71.89 | |
Aetna
| Professional | $71.89 | $71.89 | $73.20 | |
Cigna
| Facility | $70.36 | $70.36 | $70.36 | |
Cigna
| Professional | $53.76 | $70.36 | $70.36 | |
Medica
| Facility | $60.24 | $74.79 | $272.63 | |
Medica
| Professional | $60.52 | $75.17 | $76.58 | |
United
| Professional | $60.52 | $75.17 | $76.58 |