| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.83 | $67.52 | $753.41 | |
Aetna
| Professional | $9.15 | $11.38 | $22.46 | |
Cigna
| Facility | $17.32 | $17.32 | $17.32 | |
Cigna
| Professional | $17.32 | $17.32 | $17.32 | |
Medica
| Facility | $11.50 | $21.49 | $61.82 | |
Medica
| Professional | $20.38 | $20.38 | $136.72 | |
United
| Professional | $20.38 | $20.38 | $21.20 |