| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.40 | $36.40 | $36.40 | |
Aetna
| Professional | $35.86 | $36.40 | $39.61 | |
Cigna
| Professional | $24.95 | $24.95 | $24.95 | |
Medica
| Facility | $35.86 | $61.14 | $130.84 | |
Medica
| Professional | $19.79 | $35.71 | $724.41 | |
United
| Professional | $17.28 | $27.73 | $42.01 |