| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.58 | $39.58 | $47.58 | |
Aetna
| Professional | $39.00 | $39.00 | $39.58 | |
Cigna
| Facility | $39.94 | $39.94 | $45.17 | |
Cigna
| Professional | $33.95 | $39.94 | $53.10 | |
Medica
| Facility | $18.20 | $41.56 | $312.25 | |
Medica
| Professional | $18.80 | $31.69 | $65.76 | |
United
| Professional | $18.80 | $29.98 | $40.44 |