| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $98.01 | $98.01 | $98.01 | |
Aetna
| Professional | $98.01 | $98.01 | $99.22 | |
Cigna
| Facility | $102.85 | $102.85 | $102.85 | |
Cigna
| Professional | $102.85 | $102.85 | $102.85 | |
Medica
| Facility | $0.08 | $102.85 | $121.00 | |
Medica
| Professional | $110.00 | $110.00 | $459.80 | |
United
| Professional | $105.71 | $110.00 | $124.30 |