| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $77.70 | $77.70 | $101.47 | |
Cigna
| Professional | $107.63 | $108.70 | $136.68 | |
Medica
| Facility | $77.70 | $101.47 | $122.04 | |
Medica
| Professional | $36.97 | $48.62 | $607.76 | |
United
| Professional | $35.75 | $38.04 | $122.47 |