| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $128.82 | $128.82 | |
Aetna
| Professional | $95.50 | $112.20 | $151.36 | |
Cigna
| Professional | $131.83 | $134.90 | $165.96 | |
Medica
| Facility | $97.72 | $128.82 | $218.78 | |
Medica
| Professional | $141.25 | $234.42 | $776.25 | |
United
| Professional | $141.25 | $234.42 | $323.59 |