| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.63 | $13.63 | $8,500.00 | |
Aetna
| Professional | $13.63 | $13.63 | $67.02 | |
Cigna
| Professional | $32.25 | $32.25 | $40.31 | |
Medica
| Facility | $13.63 | $13.63 | $101.84 | |
Medica
| Professional | $21.30 | $38.85 | $50.93 | |
United
| Professional | $22.76 | $41.38 | $61.98 |