| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.99 | $169.99 | $169.99 | |
Aetna
| Professional | $78.66 | $191.00 | $211.75 | |
Cigna
| Professional | $68.73 | $68.73 | $68.73 | |
Medica
| Facility | $159.25 | $196.73 | $283.08 | |
Medica
| Professional | $98.70 | $124.27 | $542.51 | |
United
| Professional | $94.00 | $117.50 | $191.00 |