| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.79 | $39.79 | $39.79 | |
Aetna
| Professional | $26.08 | $43.22 | $48.48 | |
Cigna
| Professional | $15.38 | $15.53 | $19.53 | |
Medica
| Facility | $24.08 | $39.79 | $68.87 | |
Medica
| Professional | $49.22 | $93.04 | $280.19 | |
United
| Professional | $41.35 | $87.87 | $158.16 |