| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.68 | $12.68 | $12.68 | |
Aetna
| Professional | $12.67 | $12.67 | $12.68 | |
Cigna
| Professional | $11.25 | $11.36 | $14.06 | |
Medica
| Facility | $12.68 | $12.68 | $21.56 | |
Medica
| Professional | $48.07 | $52.88 | $54.58 | |
United
| Professional | $51.46 | $56.61 | $58.15 |