| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.16 | $67.16 | $67.16 | |
Aetna
| Professional | $67.15 | $67.16 | $73.87 | |
Cigna
| Professional | $66.00 | $66.66 | $82.50 | |
Medica
| Facility | $25.23 | $67.16 | $201.48 | |
Medica
| Professional | $71.78 | $72.70 | $79.01 | |
United
| Professional | $66.09 | $72.70 | $74.68 |