| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.33 | $70.33 | $70.33 | |
Aetna
| Professional | $70.33 | $72.97 | $87.91 | |
Cigna
| Professional | $136.94 | $136.94 | $377.97 | |
Medica
| Facility | $70.33 | $91.43 | $133.46 | |
Medica
| Professional | $83.51 | $83.51 | $1,337.71 | |
United
| Professional | $83.51 | $83.51 | $91.86 |