| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Cigna
| Facility | $888.58 | $888.58 | $1,021.87 | |
Cigna
| Professional | $507.75 | $512.83 | $634.69 | |
Medica
| Facility | $40.00 | $40.00 | $68.00 |