| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.08 | $122.90 | $122.90 | |
Cigna
| Professional | $170.25 | $171.95 | $216.22 | |
Medica
| Facility | $104.08 | $110.50 | $146.72 | |
Medica
| Professional | $49.87 | $59.84 | $801.07 | |
United
| Professional | $48.89 | $49.87 | $62.45 |