| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.69 | $41.69 | $41.69 | |
Aetna
| Professional | $38.02 | $43.65 | $57.54 | |
Cigna
| Professional | $43.65 | $43.65 | $43.65 | |
Medica
| Facility | $41.69 | $44.67 | $79.43 | |
Medica
| Professional | $44.67 | $58.88 | $331.13 | |
United
| Professional | $44.67 | $57.54 | $75.86 |