| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $141.25 | $165.96 | |
Aetna
| Professional | $120.23 | $169.82 | $380.19 | |
Cigna
| Professional | $112.20 | $147.91 | $398.11 | |
Medica
| Facility | $141.25 | $194.98 | $288.40 | |
Medica
| Professional | $162.18 | $309.03 | $1,000.00 | |
United
| Professional | $147.91 | $257.04 | $363.08 |