| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.41 | $19.41 | $37.11 | |
Aetna
| Professional | $19.41 | $24.26 | $24.26 | |
Cigna
| Professional | $33.00 | $33.00 | $41.25 | |
Medica
| Facility | $19.41 | $19.41 | $58.23 | |
Medica
| Professional | $19.64 | $19.64 | $21.34 | |
United
| Professional | $16.70 | $19.64 | $21.34 |