| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.34 | $11.34 | $11.34 | |
Aetna
| Professional | $11.34 | $11.34 | $11.34 | |
Cigna
| Professional | $26.63 | $26.63 | $33.28 | |
Medica
| Facility | $11.34 | $11.34 | $34.02 | |
Medica
| Professional | $25.98 | $46.51 | $56.07 | |
United
| Professional | $28.42 | $45.98 | $56.07 |