| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.72 | $97.72 | $165.96 | |
Aetna
| Professional | $97.72 | $100.00 | $120.23 | |
Cigna
| Professional | $11.75 | $11.75 | $11.75 | |
Medica
| Facility | $89.13 | $107.15 | $741.31 | |
Medica
| Professional | $91.20 | $102.33 | $102.33 | |
United
| Professional | $102.33 | $102.33 | $102.33 |