| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.20 | $25.12 | $75.86 | |
Aetna
| Professional | $15.85 | $19.05 | $25.12 | |
Cigna
| Facility | $16.22 | $16.22 | $67.61 | |
Medica
| Facility | $18.62 | $25.12 | $39.81 | |
Medica
| Professional | $10.47 | $11.75 | $125.89 | |
United
| Facility | $10.47 | $25.12 | $30.20 | |
United
| Professional | $10.47 | $10.47 | $16.60 |