| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.50 | $90.50 | $90.50 | |
Aetna
| Professional | $89.17 | $90.50 | $98.49 | |
Cigna
| Professional | $62.01 | $62.01 | $62.01 | |
Medica
| Facility | $89.17 | $99.55 | $243.18 | |
Medica
| Professional | $49.19 | $88.82 | $835.71 | |
United
| Professional | $49.19 | $72.44 | $104.49 |