| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.35 | $49.53 | $128.79 | |
Aetna
| Professional | $26.71 | $30.02 | $38.90 | |
Cigna
| Facility | $125.15 | $142.05 | $333.69 | |
Medica
| Facility | $29.35 | $36.90 | $119.26 | |
Medica
| Professional | $42.42 | $48.78 | $269.37 | |
United
| Professional | $42.42 | $46.66 | $72.18 |