| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.82 | $33.82 | $33.82 | |
Aetna
| Professional | $21.25 | $33.82 | $40.28 | |
Cigna
| Professional | $18.97 | $18.97 | $33.47 | |
Medica
| Facility | $21.50 | $38.00 | $45.79 | |
Medica
| Professional | $27.50 | $33.75 | $149.71 | |
United
| Professional | $27.00 | $33.75 | $43.79 |