| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.43 | $59.43 | $59.43 | |
Aetna
| Professional | $57.23 | $59.43 | $59.81 | |
Cigna
| Facility | $56.50 | $56.50 | $56.50 | |
Cigna
| Professional | $41.25 | $56.50 | $56.50 | |
Medica
| Facility | $59.43 | $62.40 | $638.99 | |
Medica
| Professional | $52.11 | $83.38 | $145.49 | |
United
| Professional | $52.11 | $78.17 | $145.49 |