| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $98.36 | $98.36 | $195.74 | |
Aetna
| Professional | $98.36 | $98.36 | $98.36 | |
Cigna
| Professional | $11.82 | $11.82 | $11.82 | |
Medica
| Facility | $88.52 | $106.25 | $734.60 | |
Medica
| Professional | $101.19 | $101.19 | $101.19 | |
United
| Professional | $101.19 | $101.19 | $103.21 |