| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.23 | $63.23 | $127.51 | |
Aetna
| Professional | $63.23 | $79.40 | $79.40 | |
Cigna
| Professional | $14.63 | $14.63 | $18.28 | |
Medica
| Facility | $16.00 | $63.23 | $189.69 | |
Medica
| Professional | $16.00 | $16.00 | $17.38 | |
United
| Professional | $13.60 | $16.00 | $17.38 |