| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.26 | $38.26 | $38.26 | |
Aetna
| Professional | $37.04 | $39.35 | $48.48 | |
Cigna
| Professional | $100.99 | $100.99 | $100.99 | |
Medica
| Facility | $30.33 | $38.26 | $51.65 | |
Medica
| Professional | $42.22 | $56.29 | $280.19 | |
United
| Professional | $43.32 | $54.27 | $92.67 |