| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.35 | $14.35 | $14.35 | |
Aetna
| Professional | $14.35 | $14.35 | $15.11 | |
Cigna
| Professional | $10.19 | $10.19 | $10.19 | |
Medica
| Facility | $0.11 | $15.87 | $59.99 | |
Medica
| Professional | $5.74 | $12.31 | $17.17 | |
United
| Professional | $5.74 | $12.89 | $17.17 |