| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.21 | $92.21 | $92.21 | |
Aetna
| Professional | $67.56 | $92.21 | $95.43 | |
Cigna
| Professional | $80.29 | $111.00 | $199.02 | |
Medica
| Facility | $54.62 | $119.87 | $156.76 | |
Medica
| Professional | $20.66 | $57.47 | $633.60 | |
United
| Professional | $20.66 | $41.93 | $94.45 |