| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.79 | $39.79 | $39.79 | |
Aetna
| Professional | $19.05 | $39.79 | $43.87 | |
Cigna
| Professional | $15.38 | $15.53 | $19.53 | |
Medica
| Facility | $24.08 | $39.79 | $52.92 | |
Medica
| Professional | $46.13 | $93.04 | $248.34 | |
United
| Professional | $31.79 | $82.80 | $108.55 |