| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.91 | $28.91 | $55.30 | |
Aetna
| Professional | $28.91 | $30.00 | $36.14 | |
Cigna
| Professional | $9.00 | $11.25 | $30.72 | |
Medica
| Facility | $24.75 | $29.70 | $37.58 | |
Medica
| Professional | $30.00 | $33.40 | $722.89 | |
United
| Professional | $30.00 | $30.00 | $36.27 |