| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.00 | $2.00 | $2.00 | |
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
Cigna
| Facility | $549.54 | $549.54 | $691.83 | |
Cigna
| Professional | $371.54 | $371.54 | $467.74 | |
Medica
| Facility | $2.82 | $4.79 | $7.76 | |
Wellmark
| Professional | $72.44 | $72.44 | $72.44 |