| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.95 | $47.95 | $47.95 | |
Aetna
| Professional | $46.17 | $47.95 | $53.96 | |
Cigna
| Facility | $53.85 | $53.85 | $53.85 | |
Cigna
| Professional | $39.31 | $53.85 | $53.85 | |
Medica
| Facility | $47.53 | $63.12 | $313.42 | |
Medica
| Professional | $28.66 | $48.33 | $99.02 | |
United
| Professional | $28.66 | $45.80 | $67.45 |