| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.52 | $23.52 | $52.92 | |
Aetna
| Professional | $23.52 | $24.39 | $29.40 | |
Cigna
| Professional | $25.50 | $25.50 | $31.88 | |
Medica
| Facility | $23.52 | $29.40 | $39.97 | |
Medica
| Professional | $29.40 | $29.40 | $31.93 | |
United
| Professional | $24.99 | $29.40 | $31.93 |