| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.09 | $71.09 | $159.97 | |
Aetna
| Professional | $71.09 | $88.88 | $88.88 | |
Cigna
| Professional | $72.38 | $73.09 | $90.47 | |
Medica
| Facility | $71.09 | $88.88 | $120.87 | |
Medica
| Professional | $88.88 | $88.88 | $96.53 | |
United
| Professional | $75.55 | $88.88 | $96.53 |