| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $14.82 | |
Aetna
| Professional | $14.82 | $14.82 | $102.29 | |
Cigna
| Professional | $4.38 | $4.38 | $11.72 | |
Medica
| Facility | $14.82 | $14.82 | $41.64 | |
Medica
| Professional | $3.75 | $5.59 | $9.39 | |
United
| Professional | $3.75 | $5.40 | $9.38 |