| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.00 | $94.00 | $94.00 | |
Aetna
| Professional | $94.00 | $140.00 | $192.91 | |
Cigna
| Professional | $68.73 | $213.62 | $268.61 | |
Medica
| Facility | $94.00 | $145.57 | $282.00 | |
Medica
| Professional | $90.00 | $169.00 | $542.51 | |
United
| Professional | $86.73 | $153.00 | $223.15 |