| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.57 | $52.57 | $52.57 | |
Aetna
| Professional | $52.57 | $52.57 | $52.57 | |
Cigna
| Facility | $135.54 | $135.54 | $135.54 | |
Medica
| Facility | $52.57 | $693.04 | $5,833.89 | |
Medica
| Professional | $50.31 | $73.80 | $547.67 | |
United
| Facility | $350.00 | $1,760.00 | $6,155.68 | |
United
| Professional | $47.35 | $65.11 | $100.48 |