| 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
| Facility | $651.32 | $651.32 | $749.01 | |
Cigna
| Professional | $372.00 | $375.72 | $465.00 | |
Medica
| Facility | $2.81 | $2.81 | $4.78 |