| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.39 | $46.25 | $46.25 | |
Aetna
| Professional | $46.25 | $46.25 | $59.61 | |
Cigna
| Facility | $135.54 | $135.54 | $135.54 | |
Medica
| Facility | $39.31 | $48.56 | $93.26 | |
Medica
| Professional | $48.50 | $63.58 | $178.16 | |
United
| Facility | $63.39 | $67.12 | $74.39 | |
United
| Professional | $48.50 | $60.63 | $89.05 |