| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.90 | $38.90 | $56.23 | |
Aetna
| Professional | $33.11 | $52.48 | $64.57 | |
Cigna
| Professional | $70.79 | $104.71 | $131.83 | |
Medica
| Facility | $38.90 | $61.66 | $97.72 | |
Medica
| Professional | $61.66 | $104.71 | $338.84 | |
United
| Professional | $57.54 | $95.50 | $138.04 |