| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.81 | $66.81 | $66.81 | |
Aetna
| Professional | $66.81 | $75.43 | $75.43 | |
Cigna
| Facility | $37.90 | $54.91 | $122.92 | |
Medica
| Facility | $66.81 | $75.43 | $112.53 | |
Medica
| Professional | $44.39 | $57.99 | $614.40 | |
United
| Professional | $44.39 | $58.82 | $102.14 |