| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $98.16 | $98.16 | $220.86 | |
Aetna
| Professional | $98.16 | $122.70 | $122.70 | |
Cigna
| Professional | $110.25 | $110.25 | $137.81 | |
Medica
| Facility | $39.78 | $122.70 | $166.87 | |
Medica
| Professional | $122.70 | $122.70 | $133.26 | |
United
| Professional | $104.30 | $122.70 | $133.26 |