| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.34 | $51.34 | $98.19 | |
Aetna
| Professional | $51.34 | $64.18 | $64.18 | |
Cigna
| Professional | $60.75 | $60.75 | $75.94 | |
Medica
| Facility | $51.34 | $64.18 | $87.28 | |
Medica
| Professional | $56.42 | $56.42 | $61.27 | |
United
| Professional | $47.96 | $56.42 | $61.27 |