| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.99 | $23.99 | $25.12 | |
Aetna
| Professional | $23.99 | $23.99 | $25.12 | |
Cigna
| Professional | $24.55 | $24.55 | $30.90 | |
Medica
| Facility | $25.12 | $33.11 | $74.13 | |
Medica
| Professional | $29.51 | $32.36 | $32.36 | |
United
| Professional | $29.51 | $32.36 | $32.36 |