| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.20 | $44.20 | $87.96 | |
Aetna
| Professional | $44.20 | $44.20 | $72.43 | |
Cigna
| Facility | $49.22 | $49.22 | $49.22 | |
Cigna
| Professional | $49.22 | $49.22 | $54.75 | |
Medica
| Facility | $44.20 | $46.41 | $316.83 | |
Medica
| Professional | $12.58 | $14.46 | $14.80 | |
United
| Professional | $10.54 | $16.22 | $16.87 |