| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.60 | $30.80 | $33.34 | |
Cigna
| Professional | $21.47 | $25.72 | $29.53 | |
Medica
| Facility | $25.28 | $32.09 | $74.87 | |
Medica
| Professional | $54.63 | $94.69 | $199.18 | |
United
| Professional | $36.92 | $87.68 | $129.76 |