| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.60 | $406.34 | $406.34 | |
Cigna
| Professional | $101.25 | $102.26 | $128.59 | |
Medica
| Facility | $35.60 | $35.60 | $406.34 | |
Medica
| Professional | $46.95 | $88.38 | $3,919.21 | |
United
| Professional | $46.77 | $93.52 | $110.48 |