| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.90 | $14.90 | $33.52 | |
Aetna
| Professional | $14.90 | $18.62 | $18.62 | |
Cigna
| Professional | $16.88 | $17.04 | $21.09 | |
Medica
| Facility | $14.90 | $16.30 | $90.00 | |
Medica
| Professional | $7.40 | $18.50 | $20.35 | |
United
| Professional | $6.92 | $17.30 | $19.39 |