| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.76 | $137.76 | $137.76 | |
Aetna
| Professional | $137.75 | $137.76 | $140.30 | |
Cigna
| Facility | $134.47 | $134.47 | $134.47 | |
Cigna
| Professional | $86.78 | $134.47 | $134.47 | |
Medica
| Facility | $110.35 | $137.76 | $512.54 | |
Medica
| Professional | $114.06 | $134.99 | $144.07 | |
United
| Professional | $114.06 | $134.99 | $144.07 |