| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.88 | $81.28 | $81.28 | |
Aetna
| Professional | $39.81 | $79.43 | $112.20 | |
Cigna
| Professional | $46.77 | $46.77 | $57.54 | |
Medica
| Facility | $40.74 | $81.28 | $138.04 | |
Medica
| Professional | $39.81 | $39.81 | $39.81 | |
United
| Facility | $33.88 | $33.88 | $33.88 |