| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $103.37 | $103.37 | $119.32 | |
Cigna
| Professional | $143.25 | $144.68 | $181.93 | |
Medica
| Facility | $103.37 | $119.32 | $142.90 | |
Medica
| Professional | $44.75 | $57.17 | $714.58 | |
United
| Professional | $42.04 | $44.75 | $114.34 |