| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.15 | $47.15 | $106.09 | |
Aetna
| Professional | $47.15 | $48.92 | $58.94 | |
Cigna
| Professional | $52.07 | $53.40 | $66.31 | |
Medica
| Facility | $47.15 | $50.10 | $61.30 | |
Medica
| Professional | $58.94 | $65.61 | $73.48 | |
United
| Professional | $58.94 | $58.94 | $73.48 |