| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.54 | $103.54 | $232.96 | |
Aetna
| Professional | $103.54 | $129.41 | $129.41 | |
Cigna
| Professional | $115.50 | $115.50 | $144.38 | |
Medica
| Facility | $103.54 | $147.50 | $310.62 | |
Medica
| Professional | $129.41 | $129.41 | $140.56 | |
United
| Professional | $110.01 | $129.41 | $140.56 |