| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.62 | $11.62 | $26.14 | |
Aetna
| Professional | $11.62 | $14.52 | $14.52 | |
Cigna
| Professional | $15.00 | $15.00 | $18.75 | |
Medica
| Facility | $11.62 | $14.52 | $19.75 | |
Medica
| Professional | $14.52 | $14.52 | $15.77 | |
United
| Professional | $14.52 | $14.52 | $15.77 |