| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $223.87 | $223.87 | $223.87 | |
Cigna
| Facility | $64.57 | $75.86 | $190.55 | |
Medica
| Facility | $109.65 | $109.65 | $109.65 | |
Quartz
| Facility | $64.57 | $75.86 | $109.65 | |
Security Health
| Facility | $128.82 | $165.96 | $181.97 |