| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $92.76 | $92.76 | $98.05 | |
Cigna
| Professional | $73.14 | $73.14 | $87.63 | |
Medica
| Facility | $92.76 | $97.40 | $123.28 | |
Medica
| Professional | $103.38 | $127.72 | $778.48 | |
United
| Professional | $103.38 | $127.52 | $194.32 |