| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.49 | $5.49 | $11.07 | |
Aetna
| Professional | $5.49 | $6.28 | $9.61 | |
Cigna
| Professional | $6.55 | $6.82 | $8.57 | |
Medica
| Facility | $5.49 | $9.85 | $11.59 | |
Medica
| Professional | $11.59 | $12.90 | $990.60 | |
United
| Professional | $11.59 | $12.90 | $14.37 |