| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.26 | $41.26 | $41.26 | |
Aetna
| Professional | $41.26 | $41.26 | $41.26 | |
Cigna
| Facility | $135.54 | $135.54 | $135.54 | |
Medica
| Facility | $36.82 | $43.32 | $242.33 | |
Medica
| Professional | $46.01 | $64.50 | $426.56 | |
United
| Professional | $43.30 | $59.68 | $104.33 |