| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.46 | $24.46 | $24.46 | |
Aetna
| Professional | $24.46 | $24.46 | $24.46 | |
Cigna
| Professional | $76.13 | $76.89 | $96.68 | |
Medica
| Facility | $8.24 | $24.46 | $117.55 | |
United
| Professional | $9.94 | $9.94 | $9.94 |