| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.45 | $57.45 | $57.45 | |
Aetna
| Professional | $47.49 | $57.45 | $93.00 | |
Cigna
| Professional | $14.25 | $61.13 | $76.41 | |
Medica
| Facility | $57.45 | $57.45 | $106.28 | |
Medica
| Professional | $52.61 | $60.00 | $75.00 | |
United
| Professional | $48.00 | $48.00 | $48.00 |