| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.14 | $89.14 | $89.14 | |
Aetna
| Professional | $43.37 | $70.83 | $89.14 | |
Cigna
| Professional | $65.77 | $65.77 | $65.77 | |
Medica
| Facility | $61.99 | $89.14 | $118.93 | |
Medica
| Professional | $65.52 | $85.56 | $472.57 | |
United
| Professional | $64.95 | $84.74 | $109.39 |