| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.84 | $33.84 | $33.84 | |
Aetna
| Professional | $33.84 | $38.20 | $38.20 | |
Cigna
| Facility | $37.90 | $54.91 | $122.92 | |
Medica
| Facility | $37.19 | $38.20 | $69.42 | |
Medica
| Professional | $43.11 | $59.31 | $311.68 | |
United
| Professional | $42.95 | $57.56 | $103.00 |