| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $106.93 | $211.13 | $252.65 | |
Cigna
| Professional | $105.09 | $208.49 | $348.28 | |
Medica
| Professional | $198.93 | $251.71 | $1,494.45 | |
United
| Professional | $198.93 | $247.41 | $377.96 |