| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.90 | $38.90 | $38.90 | |
Aetna
| Professional | $38.02 | $40.74 | $50.12 | |
Cigna
| Professional | $26.92 | $47.86 | $70.79 | |
Medica
| Facility | $38.90 | $42.66 | $61.66 | |
Medica
| Professional | $35.48 | $46.77 | $263.03 | |
United
| Professional | $33.88 | $43.65 | $61.66 |