| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.64 | $36.10 | $874.50 | |
Aetna
| Professional | $36.11 | $36.11 | $36.11 | |
Cigna
| Professional | $21.70 | $21.70 | $21.70 | |
Medica
| Facility | $64.95 | $70.80 | $96.90 | |
Medica
| Professional | $144.21 | $144.21 | $144.21 | |
United
| Facility | $67.43 | $67.43 | $72.22 |