| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $71.95 | $71.95 | $72.13 | |
Cigna
| Professional | $99.75 | $100.75 | $126.68 | |
Medica
| Facility | $71.95 | $72.13 | $86.75 | |
Medica
| Professional | $32.56 | $35.72 | $485.71 | |
United
| Professional | $30.59 | $35.72 | $113.39 |