| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.59 | $128.59 | $128.59 | |
Aetna
| Professional | $100.74 | $115.81 | $155.97 | |
Cigna
| Professional | $133.13 | $134.46 | $169.07 | |
Medica
| Facility | $112.67 | $128.59 | $218.60 | |
Medica
| Professional | $131.01 | $241.84 | $768.84 | |
United
| Professional | $131.01 | $231.89 | $320.19 |