| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.43 | $79.43 | $79.43 | |
Cigna
| Professional | $39.81 | $39.81 | $48.98 | |
Medica
| Facility | $79.43 | $93.33 | $162.18 | |
United
| Professional | $19.95 | $63.10 | $128.82 | |
Wellmark
| Professional | $72.44 | $72.44 | $72.44 |