| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.67 | $64.67 | $145.51 | |
Aetna
| Professional | $64.67 | $80.84 | $80.84 | |
Cigna
| Professional | $73.88 | $73.88 | $92.34 | |
Medica
| Facility | $64.67 | $80.84 | $109.94 | |
Medica
| Professional | $80.84 | $80.84 | $87.80 | |
United
| Professional | $68.70 | $80.84 | $100.24 |