| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.28 | $29.28 | $74.54 | |
Aetna
| Professional | $29.28 | $38.09 | $42.10 | |
Cigna
| Facility | $48.09 | $48.09 | $48.09 | |
Cigna
| Professional | $99.94 | $99.94 | $201.14 | |
Medica
| Facility | $29.28 | $62.12 | $74.54 | |
Medica
| Professional | $41.83 | $81.95 | $262.88 | |
United
| Professional | $41.83 | $76.08 | $100.24 |