| 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
| Professional | $234.42 | $288.40 | $870.96 | |
Medica
| Facility | $29.51 | $44.67 | $57.54 | |
Medica
| Professional | $36.31 | $36.31 | $36.31 |