| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $128.82 | |
Aetna
| Professional | $87.10 | $123.03 | $128.82 | |
Cigna
| Professional | $147.91 | $147.91 | $186.21 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Professional | $125.89 | $125.89 | $141.25 |