| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.00 | $45.00 | $45.00 | |
Aetna
| Professional | $36.00 | $36.00 | $45.00 | |
Cigna
| Facility | $38.25 | $38.25 | $38.25 | |
Cigna
| Professional | $38.25 | $38.25 | $38.25 | |
Medica
| Facility | $36.00 | $45.00 | $57.60 | |
Medica
| Professional | $37.50 | $37.50 | $171.00 | |
United
| Professional | $37.50 | $37.50 | $45.00 |