| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.50 | $7.50 | $7.50 | |
Aetna
| Professional | $7.50 | $7.50 | $7.50 | |
Cigna
| Facility | $0.59 | $0.59 | $0.68 | |
Cigna
| Professional | $0.38 | $0.47 | $0.48 | |
Medica
| Facility | $7.50 | $7.50 | $12.75 |