| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.67 | $44.67 | $457.09 | |
Aetna
| Professional | $34.67 | $50.12 | $602.56 | |
Cigna
| Professional | $363.08 | $436.52 | $457.09 | |
Medica
| Facility | $34.67 | $44.67 | $2,691.53 | |
Medica
| Professional | $47.86 | $70.79 | $89.13 | |
United
| Professional | $39.81 | $64.57 | $83.18 |