| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.84 | $28.84 | $28.84 | |
Aetna
| Professional | $28.84 | $28.84 | $37.15 | |
Cigna
| Facility | $407.38 | $407.38 | $467.74 | |
Cigna
| Professional | $234.42 | $288.40 | $295.12 | |
Medica
| Facility | $29.51 | $29.51 | $54.95 |