| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.30 | $16.30 | $16.30 | |
Aetna
| Professional | $16.30 | $16.30 | $16.30 | |
Cigna
| Professional | $12.75 | $12.88 | $15.94 | |
Medica
| Facility | $16.30 | $16.30 | $27.71 | |
Medica
| Professional | $13.38 | $14.53 | $14.72 | |
United
| Professional | $13.38 | $14.72 | $15.12 |