| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $168.79 | $283.66 | $283.66 | |
Cigna
| Facility | $482.10 | $563.37 | $864.23 | |
DeanCare
| Facility | $167.53 | $205.06 | $390.72 | |
Medica
| Facility | $159.31 | $205.06 | $393.02 | |
Prevea360
| Facility | $167.53 | $203.38 | $378.89 | |
Quartz
| Professional | $331.80 | $442.51 | $627.99 |