| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.00 | $27.00 | $27.00 | |
Aetna
| Professional | $27.00 | $28.60 | $38.38 | |
Cigna
| Professional | $28.50 | $28.79 | $36.20 | |
Medica
| Facility | $24.55 | $27.00 | $45.90 | |
Medica
| Professional | $27.00 | $48.60 | $149.71 | |
United
| Professional | $27.00 | $45.00 | $58.27 |