| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.59 | $21.59 | $21.59 | |
Aetna
| Professional | $21.59 | $35.79 | $36.83 | |
Cigna
| Professional | $46.13 | $48.89 | $57.66 | |
Medica
| Facility | $21.59 | $35.61 | $64.77 | |
Medica
| Professional | $31.40 | $57.72 | $272.48 | |
United
| Professional | $33.81 | $55.58 | $69.08 |