| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $94.05 | $107.84 | $154.49 | |
Cigna
| Professional | $68.73 | $68.73 | $68.73 | |
Medica
| Facility | $96.55 | $107.84 | $164.67 | |
Medica
| Professional | $47.63 | $71.45 | $144.99 | |
United
| Professional | $47.63 | $64.58 | $102.50 |