| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.81 | $39.81 | $39.81 | |
Cigna
| Facility | $36.31 | $36.31 | $36.31 | |
Cigna
| Professional | $21.88 | $36.31 | $45.71 | |
Medica
| Facility | $15.85 | $15.85 | $38.02 | |
Wellmark
| Professional | $23.99 | $23.99 | $23.99 |