| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.10 | $29.10 | $29.10 | |
Aetna
| Professional | $27.21 | $29.10 | $29.93 | |
Cigna
| Facility | $25.42 | $25.42 | $26.94 | |
Cigna
| Professional | $26.94 | $26.94 | $26.94 | |
Medica
| Facility | $28.17 | $29.83 | $75.00 | |
Medica
| Professional | $23.25 | $26.09 | $133.71 | |
United
| Professional | $26.94 | $26.94 | $29.71 |