| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.43 | $79.43 | $79.43 | |
Aetna
| Professional | $72.44 | $72.44 | $79.43 | |
Cigna
| Facility | $72.44 | $72.44 | $72.44 | |
Cigna
| Professional | $72.44 | $72.44 | $72.44 | |
Medica
| Facility | $74.13 | $79.43 | $288.40 | |
Medica
| Professional | $70.79 | $81.28 | $89.13 | |
United
| Professional | $70.79 | $83.18 | $89.13 |