| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.65 | $54.65 | $54.65 | |
Aetna
| Professional | $40.94 | $49.44 | $66.50 | |
Cigna
| Professional | $54.75 | $55.30 | $69.53 | |
Medica
| Facility | $45.57 | $54.65 | $92.91 | |
Medica
| Professional | $55.58 | $102.99 | $332.57 | |
United
| Professional | $55.58 | $102.99 | $136.08 |