| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.42 | $109.42 | $122.70 | |
Cigna
| Professional | $151.50 | $153.02 | $192.41 | |
Medica
| Facility | $109.42 | $122.70 | $147.57 | |
Medica
| Professional | $52.05 | $58.80 | $1,015.07 | |
United
| Professional | $50.66 | $52.05 | $117.59 |