| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.61 | $68.61 | $68.61 | |
Aetna
| Professional | $66.06 | $68.61 | $76.09 | |
Cigna
| Facility | $128.79 | $128.79 | $128.79 | |
Cigna
| Professional | $94.02 | $128.79 | $128.79 | |
Medica
| Facility | $39.29 | $72.04 | $532.72 | |
Medica
| Professional | $57.99 | $93.77 | $168.87 | |
United
| Professional | $57.99 | $92.11 | $136.46 |