| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.28 | $52.38 | $101.47 | |
Aetna
| Professional | $42.28 | $42.28 | $42.28 | |
Cigna
| Facility | $27.48 | $29.04 | $29.33 | |
Cigna
| Professional | $42.28 | $48.57 | $60.71 | |
Medica
| Facility | $42.28 | $42.28 | $200.83 | |
Medica
| Professional | $17.73 | $17.76 | $42.17 | |
United
| Professional | $17.73 | $17.76 | $25.37 |