| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.02 | $39.02 | $55.01 | |
Aetna
| Professional | $39.02 | $47.64 | $62.13 | |
Cigna
| Professional | $64.43 | $71.16 | $80.59 | |
Medica
| Facility | $39.02 | $46.14 | $73.09 | |
Medica
| Professional | $62.13 | $73.09 | $342.83 | |
United
| Facility | $81.36 | $81.36 | $81.36 | |
United
| Professional | $73.09 | $73.09 | $84.05 |