| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.27 | $29.27 | $41.27 | |
Aetna
| Professional | $28.91 | $29.63 | $30.72 | |
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $30.72 | $30.72 | $30.72 | |
Medica
| Facility | $26.30 | $29.27 | $36.14 | |
Medica
| Professional | $30.00 | $31.80 | $722.89 | |
United
| Professional | $30.00 | $30.00 | $33.60 |