| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $71.20 | $71.20 | $71.20 | |
Cigna
| Facility | $136.94 | $136.94 | $136.94 | |
Cigna
| Professional | $136.94 | $136.94 | $136.94 | |
Medica
| Facility | $72.09 | $101.83 | $1,378.85 | |
Medica
| Professional | $83.51 | $83.51 | $181.22 | |
United
| Facility | $306.88 | $306.88 | $306.88 | |
United
| Professional | $83.51 | $83.51 | $83.51 |