| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $107.26 | $108.05 | $108.05 | |
Cigna
| Professional | $149.63 | $151.12 | $190.02 | |
Medica
| Facility | $107.26 | $107.26 | $128.53 | |
Medica
| Professional | $51.39 | $53.63 | $713.52 | |
United
| Professional | $50.39 | $51.39 | $170.28 |