| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.46 | $51.46 | $102.41 | |
Aetna
| Professional | $51.46 | $51.46 | $51.46 | |
Cigna
| Facility | $54.00 | $54.00 | $54.00 | |
Cigna
| Professional | $35.74 | $54.00 | $54.00 | |
Medica
| Facility | $35.59 | $54.03 | $75.00 | |
Medica
| Professional | $45.00 | $52.94 | $59.29 | |
United
| Professional | $45.00 | $52.94 | $59.29 |