| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.14 | $26.14 | $26.14 | |
Aetna
| Professional | $25.75 | $26.14 | $28.45 | |
Cigna
| Professional | $17.91 | $17.91 | $17.91 | |
Medica
| Facility | $25.75 | $36.47 | $76.83 | |
Medica
| Professional | $14.20 | $25.65 | $394.00 | |
United
| Professional | $12.41 | $20.25 | $30.18 |