| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.86 | $15.86 | $15.86 | |
Aetna
| Professional | $15.86 | $15.86 | $15.86 | |
Cigna
| Professional | $18.09 | $24.79 | $49.02 | |
Medica
| Facility | $15.86 | $25.95 | $100.00 | |
Medica
| Professional | $15.30 | $21.01 | $32.15 | |
United
| Professional | $14.35 | $21.01 | $32.83 |