| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.08 | $119.95 | $119.95 | |
Cigna
| Professional | $166.13 | $167.79 | $210.98 | |
Medica
| Facility | $119.08 | $119.95 | $143.21 | |
Medica
| Professional | $57.06 | $59.54 | $897.48 | |
United
| Professional | $55.94 | $57.06 | $114.11 |