| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.45 | $84.45 | $84.45 | |
Aetna
| Professional | $80.67 | $88.25 | $110.09 | |
Cigna
| Professional | $92.55 | $92.55 | $92.55 | |
Medica
| Facility | $83.44 | $89.08 | $167.34 | |
Medica
| Professional | $88.60 | $115.90 | $661.36 | |
United
| Professional | $88.06 | $115.90 | $152.66 |