| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.85 | $109.85 | $109.85 | |
Aetna
| Professional | $102.73 | $109.85 | $109.85 | |
Cigna
| Facility | $95.96 | $95.96 | $101.72 | |
Cigna
| Professional | $101.72 | $101.72 | $101.72 | |
Medica
| Facility | $77.62 | $114.21 | $270.57 | |
Medica
| Professional | $100.72 | $100.72 | $148.79 | |
United
| Professional | $97.75 | $101.72 | $113.93 |