| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.46 | $41.99 | $41.99 | |
Cigna
| Professional | $253.69 | $253.69 | $253.69 | |
Medica
| Facility | $41.99 | $43.25 | $165.97 | |
Medica
| Professional | $21.13 | $21.36 | $150.00 | |
United
| Professional | $21.13 | $21.36 | $150.00 |