| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.45 | $53.46 | $53.46 | |
Aetna
| Professional | $53.45 | $53.45 | $54.45 | |
Cigna
| Facility | $48.76 | $48.76 | $48.76 | |
Cigna
| Professional | $48.76 | $48.76 | $48.76 | |
Medica
| Facility | $23.46 | $39.97 | $76.45 | |
Medica
| Professional | $41.36 | $51.38 | $52.25 | |
United
| Professional | $41.36 | $51.38 | $52.25 |