| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.92 | $29.92 | $29.92 | |
Aetna
| Professional | $29.92 | $49.98 | $49.98 | |
Cigna
| Professional | $60.38 | $64.00 | $75.47 | |
Medica
| Facility | $29.92 | $43.66 | $90.31 | |
Medica
| Professional | $43.67 | $79.33 | $391.12 | |
United
| Professional | $43.67 | $78.41 | $98.34 |