| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.56 | $137.56 | $137.56 | |
Aetna
| Professional | $135.53 | $137.56 | $149.69 | |
Cigna
| Professional | $94.26 | $94.26 | $94.26 | |
Medica
| Facility | $135.53 | $171.25 | $369.63 | |
Medica
| Professional | $74.76 | $134.99 | $1,540.67 | |
United
| Professional | $65.31 | $104.50 | $158.81 |