| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.84 | $74.84 | $74.84 | |
Aetna
| Professional | $72.08 | $73.45 | $74.84 | |
Cigna
| Facility | $52.17 | $52.17 | $52.17 | |
Cigna
| Professional | $38.08 | $52.17 | $52.17 | |
Medica
| Facility | $28.81 | $78.59 | $580.79 | |
Medica
| Professional | $63.35 | $106.00 | $183.36 | |
United
| Professional | $63.35 | $102.03 | $156.97 |