| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.84 | $75.84 | $75.84 | |
Aetna
| Professional | $75.84 | $75.84 | $75.84 | |
Cigna
| Professional | $52.88 | $53.40 | $67.15 | |
Medica
| Facility | $57.82 | $74.45 | $223.38 | |
Medica
| Professional | $74.37 | $81.81 | $92.88 | |
United
| Professional | $74.37 | $81.81 | $84.04 |