| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.39 | $120.06 | $120.06 | |
Aetna
| Professional | $15.60 | $32.49 | $120.06 | |
Cigna
| Professional | $20.25 | $23.48 | $29.06 | |
Medica
| Facility | $25.89 | $46.50 | $120.06 | |
Medica
| Professional | $40.38 | $60.56 | $199.18 | |
United
| Professional | $32.35 | $47.53 | $65.78 |