| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.75 | $40.75 | $91.69 | |
Aetna
| Professional | $40.75 | $42.28 | $50.94 | |
Cigna
| Professional | $28.87 | $42.42 | $52.50 | |
Medica
| Facility | $40.75 | $50.94 | $62.66 | |
Medica
| Professional | $40.53 | $45.12 | $227.88 | |
United
| Professional | $40.53 | $40.53 | $50.26 |