| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.76 | $18.76 | $18.76 | |
Aetna
| Professional | $18.76 | $21.80 | $22.90 | |
Cigna
| Professional | $23.35 | $23.35 | $29.19 | |
Medica
| Facility | $18.76 | $31.56 | $56.28 | |
Medica
| Professional | $19.78 | $32.36 | $40.49 | |
United
| Professional | $19.78 | $26.66 | $40.49 |