| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.77 | $32.77 | $32.77 | |
Aetna
| Professional | $32.77 | $32.77 | $32.77 | |
Cigna
| Facility | $135.54 | $135.54 | $135.54 | |
Medica
| Facility | $29.25 | $32.77 | $190.76 | |
Medica
| Professional | $35.65 | $49.39 | $311.68 | |
United
| Professional | $34.36 | $47.35 | $68.94 |