| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.68 | $51.68 | $104.22 | |
Aetna
| Professional | $51.68 | $64.90 | $64.90 | |
Cigna
| Professional | $54.75 | $55.30 | $68.44 | |
Medica
| Facility | $46.94 | $64.90 | $316.83 | |
Medica
| Professional | $5.78 | $14.46 | $16.20 | |
United
| Professional | $6.49 | $16.22 | $18.17 |