| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.83 | $46.83 | $46.83 | |
Aetna
| Professional | $46.83 | $46.83 | $47.39 | |
Cigna
| Professional | $54.10 | $78.09 | $91.77 | |
Medica
| Facility | $46.83 | $400.00 | $2,490.86 | |
Medica
| Professional | $50.40 | $69.31 | $558.82 | |
United
| Facility | $100.00 | $610.00 | $1,883.00 | |
United
| Professional | $48.22 | $67.00 | $100.83 |