| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.41 | $51.41 | $87.40 | |
Aetna
| Professional | $51.41 | $51.41 | $51.41 | |
Cigna
| Facility | $53.95 | $53.95 | $53.95 | |
Cigna
| Professional | $43.68 | $53.95 | $53.95 | |
Medica
| Facility | $32.50 | $56.55 | $184.35 | |
Medica
| Professional | $52.89 | $52.89 | $52.89 | |
United
| Professional | $52.89 | $52.89 | $52.89 |