| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.71 | $87.71 | $87.71 | |
Aetna
| Professional | $44.72 | $70.72 | $87.71 | |
Cigna
| Professional | $66.06 | $66.06 | $66.06 | |
Medica
| Facility | $61.63 | $87.71 | $119.58 | |
Medica
| Professional | $63.23 | $82.62 | $472.20 | |
United
| Professional | $63.23 | $82.46 | $109.63 |