| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $14.82 | |
Aetna
| Professional | $14.27 | $14.82 | $14.91 | |
Cigna
| Facility | $54.94 | $54.94 | $54.94 | |
Cigna
| Professional | $40.11 | $40.11 | $54.94 | |
Medica
| Facility | $14.82 | $15.56 | $159.28 | |
Medica
| Professional | $12.99 | $20.79 | $36.56 | |
United
| Professional | $12.99 | $19.46 | $36.56 |