| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.49 | $34.49 | $349.38 | |
Aetna
| Professional | $34.49 | $34.49 | $39.71 | |
Cigna
| Professional | $2.02 | $2.02 | $2.02 | |
Medica
| Facility | $34.49 | $34.49 | $96.92 | |
Medica
| Professional | $20.00 | $20.00 | $122.28 |