| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.98 | $79.98 | $112.76 | |
Aetna
| Professional | $78.98 | $80.97 | $83.93 | |
Cigna
| Professional | $126.63 | $126.63 | $126.63 | |
Medica
| Facility | $79.98 | $83.98 | $98.74 | |
Medica
| Professional | $98.74 | $98.74 | $121.06 | |
United
| Professional | $98.74 | $98.74 | $118.49 |