| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.80 | $3.80 | $3.80 | |
Aetna
| Professional | $3.80 | $3.80 | $3.80 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $2.70 | $2.70 | $2.70 | |
Martin's Point
| Professional | $3.80 | $3.80 | $3.80 | |
Priority Health
| Facility | $64.00 | $64.00 | $64.00 | |
Priority Health
| Professional | $2.70 | $2.70 | $2.70 |