| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.86 | $39.86 | $39.86 | |
Aetna
| Professional | $39.86 | $60.39 | $60.39 | |
Cigna
| Professional | $79.88 | $84.67 | $99.84 | |
Medica
| Facility | $36.02 | $58.60 | $119.61 | |
Medica
| Professional | $60.63 | $111.39 | $359.53 | |
United
| Professional | $60.63 | $101.63 | $133.38 |