| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.78 | $50.78 | $97.11 | |
Aetna
| Professional | $50.78 | $63.47 | $63.47 | |
Cigna
| Professional | $49.13 | $49.62 | $61.41 | |
Medica
| Facility | $38.71 | $50.78 | $152.34 | |
Medica
| Professional | $52.89 | $52.89 | $57.44 | |
United
| Professional | $44.96 | $52.89 | $57.44 |