| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.50 | $18.50 | $18.50 | |
Aetna
| Professional | $16.82 | $19.21 | $21.41 | |
Cigna
| Professional | $18.69 | $18.69 | $22.28 | |
Medica
| Facility | $18.50 | $21.53 | $38.63 | |
Medica
| Professional | $193.44 | $193.44 | $193.44 | |
United
| Professional | $26.00 | $39.00 | $68.00 |