| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.85 | $26.85 | $26.85 | |
Aetna
| Professional | $26.85 | $26.85 | $27.34 | |
Cigna
| Facility | $27.44 | $27.44 | $27.44 | |
Cigna
| Professional | $27.44 | $27.44 | $27.44 | |
Medica
| Facility | $25.83 | $27.79 | $39.51 | |
Medica
| Professional | $26.40 | $30.39 | $33.35 | |
United
| Professional | $26.40 | $30.57 | $33.35 |