| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.40 | $38.40 | $86.40 | |
Aetna
| Professional | $38.40 | $48.00 | $48.00 | |
Cigna
| Professional | $43.50 | $43.50 | $54.38 | |
Medica
| Facility | $14.07 | $48.00 | $65.28 | |
Medica
| Professional | $50.00 | $50.00 | $54.30 | |
United
| Professional | $42.50 | $50.00 | $56.00 |