| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.13 | $57.13 | $57.13 | |
Aetna
| Professional | $45.70 | $45.70 | $57.13 | |
Cigna
| Facility | $48.56 | $48.56 | $48.56 | |
Cigna
| Professional | $48.56 | $48.56 | $48.56 | |
Medica
| Facility | $45.70 | $57.13 | $114.00 | |
Medica
| Professional | $548.62 | $1,576.28 | $1,576.28 | |
United
| Professional | $57.13 | $57.13 | $59.44 |