| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.92 | $26.92 | $38.02 | |
Aetna
| Professional | $20.89 | $28.18 | $38.02 | |
Cigna
| Professional | $28.18 | $28.84 | $35.48 | |
Medica
| Facility | $26.92 | $28.18 | $45.71 | |
Medica
| Professional | $26.92 | $48.98 | $151.36 | |
United
| Professional | $24.55 | $34.67 | $51.29 |