| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.25 | $30.25 | $54.45 | |
Aetna
| Professional | $27.67 | $30.25 | $32.10 | |
Cigna
| Professional | $55.84 | $55.84 | $73.31 | |
Medica
| Facility | $30.25 | $45.38 | $54.99 | |
Medica
| Professional | $48.99 | $84.63 | $269.37 | |
United
| Professional | $48.99 | $80.17 | $112.52 |