| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.20 | $18.20 | $18.20 | |
Aetna
| Professional | $14.65 | $16.85 | $22.17 | |
Cigna
| Professional | $18.75 | $18.94 | $23.81 | |
Medica
| Facility | $15.91 | $18.20 | $24.54 | |
Medica
| Professional | $19.13 | $34.19 | $113.84 | |
United
| Professional | $19.13 | $33.39 | $45.32 |