| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.72 | $34.72 | $34.72 | |
Aetna
| Professional | $34.72 | $61.87 | $105.30 | |
Cigna
| Professional | $134.90 | $134.90 | $141.80 | |
Medica
| Facility | $34.72 | $61.87 | $97.56 | |
Medica
| Professional | $54.37 | $92.82 | $564.65 | |
United
| Professional | $52.66 | $88.97 | $118.10 |