| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.89 | $24.89 | $24.89 | |
Aetna
| Professional | $24.89 | $25.93 | $151.13 | |
Cigna
| Professional | $25.51 | $33.72 | $43.61 | |
Medica
| Facility | $22.68 | $25.89 | $61.02 | |
Medica
| Professional | $23.93 | $32.29 | $56.67 | |
United
| Professional | $22.52 | $31.29 | $49.62 |