| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.02 | $216.77 | $216.77 | |
Aetna
| Professional | $2.02 | $2.02 | $2.02 | |
Cigna
| Professional | $93.87 | $93.87 | $93.87 | |
Medica
| Facility | $2.02 | $2.11 | $5.70 | |
Medica
| Professional | $108.93 | $108.93 | $108.93 |