| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.49 | $108.49 | $108.49 | |
Aetna
| Professional | $104.48 | $108.49 | $109.18 | |
Cigna
| Facility | $210.68 | $210.68 | $210.68 | |
Cigna
| Professional | $153.80 | $210.68 | $210.68 | |
Medica
| Facility | $108.49 | $113.91 | $1,166.45 | |
Medica
| Professional | $95.13 | $152.21 | $265.85 | |
United
| Professional | $95.13 | $142.50 | $265.85 |