| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.88 | $21.88 | $37.15 | |
Aetna
| Professional | $19.95 | $35.48 | $58.88 | |
Cigna
| Professional | $30.90 | $43.65 | $66.07 | |
Medica
| Facility | $17.78 | $22.91 | $47.86 | |
Medica
| Professional | $22.91 | $39.81 | $251.19 | |
United
| Professional | $23.99 | $39.81 | $54.95 |