| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.73 | $67.73 | $152.41 | |
Aetna
| Professional | $67.73 | $84.68 | $84.68 | |
Cigna
| Professional | $61.88 | $61.88 | $77.34 | |
Medica
| Facility | $43.67 | $84.68 | $115.16 | |
Medica
| Professional | $70.56 | $70.56 | $76.64 | |
United
| Professional | $59.98 | $70.56 | $79.04 |