| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.44 | $29.44 | $29.44 | |
Aetna
| Professional | $29.44 | $29.44 | $30.99 | |
Cigna
| Professional | $29.14 | $29.14 | $29.14 | |
Medica
| Facility | $27.42 | $32.54 | $71.86 | |
Medica
| Professional | $11.77 | $25.26 | $35.22 | |
United
| Professional | $11.77 | $26.45 | $35.22 |