| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.05 | $21.05 | $47.36 | |
Aetna
| Professional | $21.05 | $26.31 | $26.31 | |
Cigna
| Professional | $21.75 | $21.75 | $27.19 | |
Medica
| Facility | $21.05 | $26.31 | $35.79 | |
Medica
| Professional | $21.05 | $21.05 | $22.86 | |
United
| Professional | $17.89 | $21.05 | $22.86 |