| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.10 | $13.10 | $25.04 | |
Aetna
| Professional | $13.10 | $16.37 | $16.37 | |
Cigna
| Professional | $15.38 | $15.38 | $19.22 | |
Medica
| Facility | $13.10 | $13.10 | $39.29 | |
Medica
| Professional | $13.64 | $13.64 | $14.81 | |
United
| Professional | $11.59 | $13.64 | $14.81 |