| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $159.10 | $182.81 | $182.81 | |
Cigna
| Professional | $253.13 | $255.66 | $321.47 | |
Medica
| Facility | $159.10 | $176.52 | $218.26 | |
Medica
| Professional | $76.23 | $90.74 | $1,224.61 | |
United
| Professional | $74.73 | $76.23 | $152.46 |