| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.62 | $45.62 | $92.00 | |
Aetna
| Professional | $45.62 | $57.29 | $60.66 | |
Cigna
| Professional | $66.38 | $70.36 | $84.30 | |
Medica
| Facility | $45.62 | $73.09 | $94.30 | |
Medica
| Professional | $73.09 | $81.36 | $342.83 | |
United
| Professional | $73.09 | $81.36 | $91.12 |