| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.10 | $58.10 | $58.10 | |
Aetna
| Professional | $51.96 | $58.10 | $58.70 | |
Cigna
| Professional | $50.86 | $50.86 | $89.76 | |
Medica
| Facility | $55.74 | $88.59 | $110.41 | |
Medica
| Professional | $60.55 | $60.55 | $368.87 | |
United
| Professional | $60.55 | $60.55 | $67.81 |