| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.19 | $46.19 | $93.15 | |
Aetna
| Professional | $46.19 | $52.85 | $229.08 | |
Cigna
| Professional | $57.66 | $60.60 | $76.20 | |
Medica
| Facility | $46.19 | $85.45 | $234.60 | |
Medica
| Professional | $276.00 | $307.25 | $1,311.00 | |
United
| Professional | $276.00 | $276.00 | $364.32 |