| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.48 | $68.69 | $89.98 | |
Aetna
| Professional | $51.88 | $79.95 | $140.00 | |
Cigna
| Professional | $53.22 | $86.38 | $123.02 | |
Medica
| Facility | $66.70 | $94.37 | $141.52 | |
Medica
| Professional | $87.09 | $167.38 | $542.94 | |
United
| Professional | $82.44 | $150.76 | $224.05 |