| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.05 | $20.05 | $20.05 | |
Aetna
| Professional | $17.95 | $19.88 | $20.05 | |
Cigna
| Professional | $13.74 | $13.74 | $13.74 | |
Medica
| Facility | $19.76 | $27.12 | $55.57 | |
Medica
| Professional | $10.90 | $19.67 | $256.19 | |
United
| Professional | $9.52 | $15.53 | $23.14 |