| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.95 | $19.95 | $19.95 | |
Aetna
| Professional | $18.20 | $18.20 | $19.95 | |
Cigna
| Professional | $13.18 | $13.18 | $13.18 | |
Medica
| Facility | $15.85 | $18.62 | $28.84 | |
Medica
| Professional | $17.78 | $19.50 | $22.39 | |
United
| Facility | $15.85 | $15.85 | $16.60 | |
United
| Professional | $17.78 | $20.89 | $22.39 |