| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.89 | $89.89 | $89.89 | |
Aetna
| Professional | $52.44 | $101.00 | $112.53 | |
Cigna
| Professional | $45.92 | $45.92 | $45.92 | |
Medica
| Facility | $84.63 | $104.03 | $149.69 | |
Medica
| Professional | $66.00 | $83.29 | $362.37 | |
United
| Professional | $63.00 | $78.75 | $148.15 |