| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.66 | $61.66 | $61.66 | |
Aetna
| Professional | $57.54 | $64.57 | $83.18 | |
Cigna
| Professional | $66.07 | $66.07 | $66.07 | |
Medica
| Facility | $60.26 | $67.61 | $120.23 | |
Medica
| Professional | $63.10 | $85.11 | $467.74 | |
United
| Professional | $63.10 | $83.18 | $109.65 |