| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.77 | $81.28 | $81.28 | |
Aetna
| Professional | $39.81 | $46.77 | $134.90 | |
Cigna
| Professional | $31.62 | $31.62 | $39.81 | |
Medica
| Facility | $11.48 | $81.28 | $245.47 | |
Medica
| Professional | $117.49 | $204.17 | $338.84 | |
United
| Professional | $22.91 | $123.03 | $239.88 |