| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $83.93 | $106.11 | $115.27 | |
Cigna
| Professional | $102.68 | $130.63 | $179.22 | |
Medica
| Professional | $96.93 | $130.09 | $695.50 | |
United
| Professional | $96.93 | $119.60 | $204.45 |