| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $117.49 | $144.54 | $218.78 | |
Cigna
| Professional | $123.03 | $169.82 | $213.80 | |
Medica
| Professional | $125.89 | $162.18 | $1,412.54 | |
United
| Professional | $109.65 | $138.04 | $199.53 |