| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.25 | $47.00 | $112.80 | |
Aetna
| Professional | $34.78 | $34.78 | $50.29 | |
Cigna
| Facility | $30.55 | $30.55 | $125.56 | |
Cigna
| Professional | $57.35 | $57.35 | $68.70 | |
Medica
| Facility | $34.78 | $47.00 | $78.95 | |
Medica
| Professional | $19.73 | $19.73 | $70.50 | |
United
| Professional | $19.73 | $19.73 | $30.08 |