| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.04 | $68.04 | $115.67 | |
Aetna
| Professional | $67.20 | $68.04 | $69.72 | |
Cigna
| Facility | $71.40 | $71.40 | $71.40 | |
Cigna
| Professional | $71.40 | $71.40 | $71.40 | |
Medica
| Facility | $68.04 | $77.56 | $118.87 | |
Medica
| Professional | $79.80 | $79.80 | $94.32 | |
United
| Professional | $79.80 | $79.80 | $85.51 |