| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.91 | $22.91 | $22.91 | |
Aetna
| Professional | $22.91 | $22.91 | $22.91 | |
Cigna
| Professional | $70.79 | $70.79 | $89.13 | |
Medica
| Facility | $8.32 | $23.44 | $109.65 | |
United
| Professional | $8.32 | $9.33 | $10.47 |