| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.18 | $21.18 | $40.52 | |
Aetna
| Professional | $21.18 | $21.98 | $26.48 | |
Cigna
| Professional | $22.51 | $23.85 | $30.29 | |
Medica
| Facility | $21.18 | $23.39 | $26.48 | |
Medica
| Professional | $22.07 | $24.57 | $100.62 | |
United
| Professional | $22.07 | $24.57 | $27.52 |