| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.66 | $85.66 | $90.20 | |
Aetna
| Professional | $63.21 | $86.17 | $112.53 | |
Cigna
| Professional | $95.00 | $99.94 | $125.66 | |
Medica
| Facility | $76.67 | $90.20 | $140.11 | |
Medica
| Professional | $103.08 | $158.58 | $524.21 | |
United
| Professional | $87.34 | $153.50 | $173.28 |