| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $168.75 | |
Aetna
| Professional | $75.00 | $93.75 | $93.75 | |
Cigna
| Professional | $82.50 | $82.50 | $103.13 | |
Medica
| Facility | $75.00 | $93.75 | $127.50 | |
Medica
| Professional | $90.69 | $90.69 | $98.49 | |
United
| Professional | $77.09 | $90.69 | $98.49 |