| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.67 | $34.67 | $426.58 | |
Aetna
| Professional | $34.67 | $50.12 | $616.60 | |
Cigna
| Professional | $204.17 | $302.00 | $467.74 | |
Medica
| Facility | $58.88 | $58.88 | $58.88 | |
Medica
| Professional | $48.98 | $79.43 | $138.04 | |
United
| Professional | $39.81 | $69.18 | $104.71 |