| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $171.63 | $171.63 | $171.63 | |
Aetna
| Professional | $160.51 | $171.63 | $171.63 | |
Cigna
| Facility | $149.91 | $149.91 | $158.91 | |
Cigna
| Professional | $151.58 | $158.91 | $158.91 | |
Medica
| Facility | $141.83 | $171.63 | $654.50 | |
Medica
| Professional | $111.24 | $158.91 | $158.91 | |
United
| Professional | $103.30 | $158.91 | $158.91 |