| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.95 | $72.95 | $72.95 | |
Aetna
| Professional | $65.70 | $72.95 | $101.26 | |
Cigna
| Facility | $158.57 | $158.57 | $182.36 | |
Cigna
| Professional | $90.38 | $91.28 | $112.97 | |
Medica
| Facility | $72.95 | $119.03 | $214.25 | |
Medica
| Professional | $47.42 | $50.47 | $119.03 | |
United
| Professional | $33.65 | $47.42 | $94.83 |