| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
Cigna
| Professional | $13.99 | $13.99 | $13.99 | |
Medica
| Facility | $2.00 | $2.00 | $2.40 | |
Medica
| Professional | $23.39 | $30.46 | $61.70 | |
United
| Professional | $23.39 | $30.46 | $61.70 |