| 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 | $30.90 | |
Cigna
| Professional | $28.18 | $28.18 | $35.48 | |
Medica
| Facility | $25.12 | $26.92 | $42.66 | |
Medica
| Professional | $27.54 | $30.90 | $30.90 | |
United
| Professional | $27.54 | $30.90 | $30.90 |