| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.02 | $27.02 | $27.02 | |
Aetna
| Professional | $21.62 | $21.62 | $27.02 | |
Cigna
| Facility | $22.97 | $22.97 | $22.97 | |
Cigna
| Professional | $22.97 | $22.97 | $22.97 | |
Medica
| Facility | $9.48 | $21.62 | $33.22 | |
Medica
| Professional | $22.52 | $22.52 | $26.48 | |
United
| Professional | $22.52 | $22.52 | $27.02 |