| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $53.70 | $77.62 | $102.33 | |
Cigna
| Professional | $112.20 | $120.23 | $144.54 | |
Medica
| Facility | $69.18 | $102.33 | $131.83 | |
Medica
| Professional | $30.90 | $48.98 | $616.60 | |
United
| Professional | $30.90 | $36.31 | $97.72 |