| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.20 | |
Aetna
| Professional | $30.20 | $30.20 | $30.20 | |
Cigna
| Professional | $41.69 | $42.66 | $53.70 | |
Medica
| Professional | $24.55 | $24.55 | $39.81 | |
United
| Professional | $25.12 | $39.81 | $72.44 |