| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $135.54 | $135.54 | $135.54 | |
Aetna
| Professional | $135.54 | $135.54 | $138.05 | |
Cigna
| Facility | $137.94 | $137.94 | $137.94 | |
Cigna
| Professional | $119.27 | $137.94 | $137.94 | |
Medica
| Facility | $107.63 | $147.65 | $532.45 | |
Medica
| Professional | $140.27 | $162.41 | $177.18 | |
United
| Professional | $140.27 | $158.22 | $177.18 |