| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.66 | $44.66 | $88.87 | |
Aetna
| Professional | $44.66 | $44.66 | $44.66 | |
Cigna
| Facility | $46.87 | $46.87 | $46.87 | |
Cigna
| Professional | $11.48 | $46.87 | $46.87 | |
Medica
| Facility | $29.97 | $46.89 | $75.00 | |
Medica
| Professional | $45.95 | $45.95 | $45.95 | |
United
| Professional | $45.95 | $45.95 | $45.95 |