| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.91 | $20.91 | $20.91 | |
Aetna
| Professional | $20.91 | $20.91 | $21.29 | |
Cigna
| Facility | $21.40 | $21.40 | $21.40 | |
Cigna
| Professional | $21.40 | $21.40 | $21.40 | |
Medica
| Facility | $14.05 | $21.64 | $38.09 | |
Medica
| Professional | $21.64 | $25.06 | $27.34 | |
United
| Professional | $21.64 | $25.06 | $27.34 |