| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.72 | $52.72 | $52.72 | |
Aetna
| Professional | $38.79 | $52.72 | $68.23 | |
Cigna
| Facility | $65.00 | $65.00 | $65.00 | |
Cigna
| Professional | $55.25 | $55.25 | $66.44 | |
Medica
| Facility | $53.77 | $69.20 | $186.74 | |
Medica
| Professional | $30.37 | $55.52 | $100.25 | |
United
| Professional | $30.37 | $45.56 | $92.54 |