| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.81 | $2.81 | $2.81 | |
Aetna
| Professional | $2.81 | $2.81 | $2.81 | |
Cigna
| Professional | $99.00 | $99.00 | $99.00 | |
Medica
| Facility | $2.81 | $2.92 | $7.90 | |
Medica
| Professional | $108.32 | $108.32 | $108.32 |