| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $43.90 | $43.90 | $43.90 | |
Aetna
| Professional | $39.29 | $43.51 | $43.90 | |
Cigna
| Professional | $30.08 | $30.08 | $30.08 | |
Medica
| Facility | $43.26 | $60.39 | $129.03 | |
Medica
| Professional | $23.86 | $43.06 | $648.41 | |
United
| Professional | $20.84 | $33.35 | $50.66 |