| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.90 | |
Aetna
| Professional | $19.05 | $30.20 | $42.66 | |
Cigna
| Professional | $34.67 | $34.67 | $43.65 | |
Medica
| Facility | $30.90 | $32.36 | $52.48 | |
Medica
| Professional | $33.88 | $38.02 | $38.02 | |
United
| Professional | $33.88 | $38.02 | $38.02 |