| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.09 | $205.90 | $234.93 | |
Cigna
| Professional | $108.53 | $108.53 | $108.53 | |
Medica
| Facility | $201.43 | $227.01 | $346.64 | |
Medica
| Professional | $75.20 | $143.69 | $305.19 | |
United
| Professional | $75.20 | $112.80 | $161.83 |