| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.86 | $83.18 | $141.25 | |
Aetna
| Professional | $75.86 | $77.62 | $89.13 | |
Cigna
| Facility | $72.44 | $72.44 | $75.86 | |
Cigna
| Professional | $75.86 | $75.86 | $75.86 | |
Medica
| Facility | $77.62 | $89.13 | $398.11 | |
Medica
| Professional | $77.62 | $77.62 | $79.43 | |
United
| Professional | $75.86 | $75.86 | $79.43 |