| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.99 | $37.39 | $54.46 | |
Aetna
| Professional | $18.18 | $33.99 | $43.54 | |
Cigna
| Facility | $104.75 | $104.75 | $136.56 | |
Medica
| Facility | $33.99 | $37.39 | $296.60 | |
Medica
| Professional | $36.01 | $42.85 | $74.40 | |
United
| Professional | $35.63 | $43.08 | $56.83 |