| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.76 | $97.76 | $97.76 | |
Aetna
| Professional | $96.72 | $96.72 | $97.76 | |
Cigna
| Professional | $58.65 | $118.88 | $148.59 | |
Medica
| Facility | $96.72 | $97.76 | $166.19 | |
United
| Professional | $127.19 | $127.19 | $127.19 |