| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.66 | $99.66 | $99.66 | |
Aetna
| Professional | $94.55 | $102.62 | $130.51 | |
Cigna
| Professional | $107.43 | $107.43 | $107.43 | |
Medica
| Facility | $98.46 | $104.64 | $197.40 | |
Medica
| Professional | $107.95 | $141.79 | $768.84 | |
United
| Professional | $104.81 | $139.46 | $179.83 |