| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.02 | $2.02 | $2.02 | |
Aetna
| Professional | $2.02 | $2.02 | $2.02 | |
Cigna
| Facility | $402.89 | $402.89 | $463.32 | |
Cigna
| Professional | $230.25 | $232.55 | $287.81 | |
Medica
| Facility | $2.02 | $2.02 | $3.45 |