| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.71 | $104.71 | $104.71 | |
Aetna
| Professional | $52.48 | $104.71 | $123.03 | |
Cigna
| Professional | $61.66 | $151.36 | $190.55 | |
Medica
| Facility | $104.71 | $141.25 | $234.42 | |
Medica
| Professional | $42.66 | $64.57 | $102.33 | |
United
| Facility | $131.83 | $131.83 | $131.83 | |
United
| Professional | $46.77 | $64.57 | $87.10 |