| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.78 | $13.10 | $13.58 | |
Cigna
| Facility | $13.58 | $13.58 | $13.58 | |
Cigna
| Professional | $13.58 | $13.58 | $13.58 | |
Medica
| Facility | $9.99 | $12.94 | $15.98 | |
Medica
| Professional | $1.44 | $2.31 | $16.73 | |
United
| Professional | $1.44 | $1.88 | $3.81 |