| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.71 | $47.71 | $56.69 | |
Cigna
| Professional | $66.00 | $66.66 | $83.82 | |
Medica
| Facility | $47.71 | $56.69 | $68.18 | |
Medica
| Professional | $22.36 | $27.16 | $339.54 | |
United
| Professional | $21.01 | $22.36 | $54.32 |