| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.37 | $62.37 | $62.37 | |
Aetna
| Professional | $30.49 | $47.60 | $62.37 | |
Cigna
| Professional | $44.04 | $44.04 | $44.04 | |
Medica
| Facility | $43.56 | $62.37 | $79.50 | |
Medica
| Professional | $45.62 | $59.87 | $332.57 | |
United
| Professional | $45.62 | $59.87 | $76.98 |