| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.04 | $17.04 | $17.04 | |
Aetna
| Professional | $17.04 | $24.46 | $26.08 | |
Cigna
| Professional | $34.86 | $34.86 | $34.86 | |
Medica
| Facility | $15.96 | $22.96 | $41.36 | |
Medica
| Professional | $24.90 | $45.59 | $193.04 | |
United
| Professional | $24.90 | $43.70 | $54.78 |