| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.43 | $71.20 | $87.59 | |
Aetna
| Professional | $26.70 | $52.90 | $78.45 | |
Cigna
| Professional | $50.29 | $50.29 | $50.29 | |
Medica
| Facility | $35.22 | $68.84 | $144.86 | |
Medica
| Professional | $56.75 | $95.67 | $488.59 | |
United
| Professional | $55.53 | $84.61 | $160.87 |