| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.51 | $20.51 | $20.51 | |
Aetna
| Professional | $20.51 | $20.51 | $21.59 | |
Cigna
| Professional | $20.35 | $20.35 | $20.35 | |
Medica
| Facility | $19.34 | $22.67 | $50.06 | |
Medica
| Professional | $8.19 | $17.61 | $24.56 | |
United
| Professional | $8.19 | $17.61 | $24.56 |