| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.88 | $120.23 | $154.88 | |
Cigna
| Professional | $69.18 | $69.18 | $69.18 | |
Medica
| Facility | $83.18 | $144.54 | $208.93 | |
Medica
| Professional | $66.07 | $70.79 | $891.25 | |
United
| Professional | $58.88 | $70.79 | $104.71 |