| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $123.34 | $123.34 | $123.61 | |
Cigna
| Professional | $170.63 | $172.33 | $216.69 | |
Medica
| Facility | $123.34 | $123.61 | $148.66 | |
Medica
| Professional | $55.37 | $61.22 | $871.65 | |
United
| Professional | $52.02 | $55.37 | $118.46 |