| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.80 | $99.80 | $147.08 | |
Aetna
| Professional | $96.10 | $99.80 | $112.50 | |
Cigna
| Facility | $149.11 | $149.11 | $149.11 | |
Cigna
| Professional | $108.85 | $149.11 | $149.11 | |
Medica
| Facility | $60.40 | $126.75 | $977.65 | |
Medica
| Professional | $62.38 | $100.60 | $208.74 | |
United
| Professional | $62.38 | $93.57 | $134.22 |