| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.09 | $28.09 | $28.09 | |
Aetna
| Professional | $27.68 | $28.09 | $28.98 | |
Cigna
| Professional | $19.25 | $19.25 | $19.25 | |
Medica
| Facility | $27.68 | $47.18 | $109.85 | |
Medica
| Professional | $15.27 | $27.58 | $609.54 | |
United
| Professional | $13.34 | $21.34 | $32.45 |