| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.49 | $21.49 | $21.49 | |
Aetna
| Professional | $19.23 | $21.30 | $21.49 | |
Cigna
| Professional | $14.73 | $14.73 | $14.73 | |
Medica
| Facility | $21.18 | $29.33 | $63.18 | |
Medica
| Professional | $11.68 | $21.09 | $302.14 | |
United
| Professional | $10.21 | $16.32 | $24.81 |