| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.94 | $14.86 | $121.94 | |
Cigna
| Professional | $21.00 | $27.78 | $290.74 | |
Medica
| Facility | $11.94 | $14.86 | $110.00 | |
Medica
| Professional | $23.82 | $145.91 | $806.50 | |
United
| Professional | $23.82 | $130.28 | $263.10 |