| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.66 | $107.66 | $107.66 | |
Aetna
| Professional | $86.33 | $96.83 | $130.50 | |
Cigna
| Professional | $114.00 | $115.14 | $144.78 | |
Medica
| Facility | $96.44 | $107.66 | $183.02 | |
Medica
| Professional | $110.07 | $202.18 | $661.36 | |
United
| Professional | $110.07 | $200.18 | $280.32 |