| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.72 | $79.72 | $79.72 | |
Aetna
| Professional | $79.72 | $79.72 | $81.20 | |
Cigna
| Facility | $72.52 | $72.52 | $72.52 | |
Cigna
| Professional | $72.52 | $72.52 | $72.52 | |
Medica
| Facility | $73.81 | $79.72 | $291.38 | |
Medica
| Professional | $70.13 | $81.20 | $88.58 | |
United
| Professional | $70.13 | $81.20 | $87.11 |