| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.53 | $38.53 | $38.53 | |
Aetna
| Professional | $38.53 | $38.53 | $49.68 | |
Cigna
| Facility | $107.02 | $107.02 | $107.02 | |
Medica
| Facility | $32.75 | $40.46 | $73.23 | |
Medica
| Professional | $35.67 | $45.85 | $89.00 | |
United
| Professional | $34.94 | $44.98 | $64.59 |