| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $202.16 | $315.43 | $315.43 | |
Aetna
| Professional | $315.43 | $315.43 | $500.50 | |
Cigna
| Facility | $33.56 | $35.31 | $68.75 | |
Cigna
| Professional | $2.48 | $2.48 | $3.10 | |
Medica
| Facility | $252.70 | $315.43 | $441.00 |