| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.03 | $33.03 | $33.03 | |
Aetna
| Professional | $28.82 | $28.82 | $41.81 | |
Cigna
| Professional | $32.25 | $34.19 | $40.31 | |
Medica
| Facility | $16.39 | $28.08 | $56.15 | |
Medica
| Professional | $11.00 | $23.64 | $225.06 | |
United
| Professional | $11.00 | $23.64 | $56.05 |