| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.74 | $20.74 | $20.74 | |
Aetna
| Professional | $20.74 | $20.74 | $21.12 | |
Cigna
| Facility | $11.89 | $11.89 | $11.89 | |
Cigna
| Professional | $11.89 | $11.89 | $12.32 | |
Medica
| Facility | $18.67 | $21.06 | $29.66 | |
Medica
| Professional | $24.45 | $28.00 | $30.89 | |
United
| Professional | $24.45 | $27.58 | $30.89 |