| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.27 | $78.27 | $78.27 | |
Aetna
| Professional | $61.76 | $70.20 | $95.73 | |
Cigna
| Professional | $81.75 | $82.57 | $103.82 | |
Medica
| Facility | $67.75 | $78.27 | $133.06 | |
Medica
| Professional | $79.76 | $148.27 | $472.57 | |
United
| Professional | $79.76 | $142.13 | $194.89 |