| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.88 | $21.88 | $22.39 | |
Aetna
| Professional | $15.49 | $21.88 | $28.18 | |
Cigna
| Professional | $22.39 | $22.39 | $28.18 | |
Medica
| Facility | $21.88 | $33.11 | $66.07 | |
Medica
| Professional | $19.50 | $21.88 | $21.88 | |
United
| Professional | $19.95 | $21.88 | $24.55 |