| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.36 | $28.36 | $28.36 | |
Aetna
| Professional | $28.36 | $28.36 | $50.00 | |
Cigna
| Facility | $12.60 | $12.60 | $12.60 | |
Cigna
| Professional | $10.71 | $12.60 | $12.60 | |
Medica
| Facility | $28.36 | $28.36 | $50.00 | |
Medica
| Professional | $8.83 | $13.25 | $22.08 | |
United
| Professional | $8.83 | $13.25 | $22.08 |