| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.50 | $47.50 | $47.50 | |
Cigna
| Professional | $18.75 | $23.44 | $29.52 | |
Medica
| Facility | $55.00 | $90.00 | $90.00 | |
Medica
| Professional | $50.00 | $87.28 | $118.70 | |
United
| Professional | $49.88 | $85.00 | $118.70 |