| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.89 | $350.81 | $350.81 | |
Aetna
| Professional | $3.74 | $14.58 | $20.59 | |
Cigna
| Professional | $17.32 | $31.13 | $38.90 | |
Medica
| Facility | $19.89 | $30.57 | $193.83 | |
Medica
| Professional | $20.38 | $20.38 | $136.72 | |
United
| Professional | $20.38 | $20.38 | $22.42 |