| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.35 | $42.35 | $42.35 | |
Aetna
| Professional | $20.50 | $25.00 | $42.35 | |
Cigna
| Professional | $18.97 | $18.97 | $18.97 | |
Medica
| Facility | $25.00 | $42.35 | $53.25 | |
Medica
| Professional | $21.48 | $27.00 | $149.71 | |
United
| Professional | $21.60 | $27.00 | $44.55 |