| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.62 | $18.62 | $18.62 | |
Aetna
| Professional | $18.62 | $18.62 | $18.62 | |
Cigna
| Professional | $15.75 | $15.91 | $19.69 | |
Medica
| Facility | $17.96 | $18.62 | $31.65 | |
Medica
| Professional | $18.62 | $20.48 | $20.48 | |
United
| Professional | $18.62 | $20.48 | $21.04 |