| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.65 | $34.65 | $34.65 | |
Aetna
| Professional | $34.65 | $38.71 | $44.22 | |
Cigna
| Professional | $42.56 | $42.56 | $42.56 | |
Medica
| Facility | $34.25 | $38.13 | $69.56 | |
Medica
| Professional | $35.51 | $48.26 | $290.08 | |
United
| Professional | $35.51 | $47.14 | $61.57 |