| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.06 | $13.06 | $13.06 | |
Aetna
| Professional | $0.31 | $12.87 | $21.80 | |
Cigna
| Facility | $17.32 | $17.32 | $17.32 | |
Cigna
| Professional | $17.32 | $17.32 | $17.32 | |
Medica
| Facility | $12.87 | $13.71 | $111.49 | |
Medica
| Professional | $20.38 | $20.38 | $25.23 | |
United
| Professional | $20.38 | $20.38 | $21.60 |