| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.35 | $102.35 | $102.35 | |
Aetna
| Professional | $43.70 | $115.00 | $127.05 | |
Cigna
| Professional | $38.22 | $38.22 | $38.22 | |
Medica
| Facility | $95.55 | $118.45 | $170.45 | |
Medica
| Professional | $54.60 | $69.00 | $301.64 | |
United
| Professional | $52.00 | $65.00 | $103.53 |