| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.50 | $2.50 | $2.50 | |
Aetna
| Professional | $2.50 | $2.50 | $2.50 | |
Cigna
| Professional | $3.00 | $3.00 | $3.00 | |
Medica
| Facility | $2.50 | $2.60 | $7.03 | |
Medica
| Professional | $15.90 | $15.90 | $15.90 |