| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.88 | $33.88 | $346.74 | |
Aetna
| Professional | $32.36 | $33.88 | $33.88 | |
Cigna
| Professional | $2.04 | $2.04 | $2.04 | |
Medica
| Facility | $32.36 | $34.67 | $89.13 | |
Medica
| Professional | $19.95 | $19.95 | $123.03 |