| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.50 | $97.50 | $97.50 | |
Aetna
| Professional | $62.41 | $67.41 | $97.50 | |
Cigna
| Facility | $58.88 | $62.41 | $62.41 | |
Cigna
| Professional | $62.41 | $62.41 | $62.41 | |
Medica
| Facility | $61.61 | $94.21 | $97.50 | |
Medica
| Professional | $59.81 | $59.81 | $332.08 | |
United
| Professional | $62.41 | $62.41 | $90.49 |