| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.17 | $41.44 | $62.16 | |
Aetna
| Professional | $16.78 | $16.78 | $20.14 | |
Cigna
| Facility | $17.27 | $17.27 | $17.27 | |
Medica
| Facility | $16.78 | $24.00 | $100.00 | |
Medica
| Professional | $20.72 | $20.72 | $20.72 | |
United
| Professional | $20.72 | $20.72 | $20.72 |