| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.52 | $38.52 | $38.52 | |
Aetna
| Professional | $37.10 | $38.52 | $38.77 | |
Cigna
| Facility | $47.13 | $47.13 | $47.13 | |
Cigna
| Professional | $34.40 | $47.13 | $47.13 | |
Medica
| Facility | $38.52 | $40.45 | $414.18 | |
Medica
| Professional | $33.78 | $54.05 | $94.46 | |
United
| Professional | $33.78 | $50.60 | $94.46 |