| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $117.49 | $141.25 | $147.91 | |
Cigna
| Professional | $204.17 | $213.80 | $257.04 | |
Medica
| Facility | $147.91 | $147.91 | $257.04 | |
Medica
| Professional | $58.88 | $72.44 | $1,778.28 | |
United
| Professional | $58.88 | $69.18 | $141.25 |