| 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 | $346.74 | $346.74 | $436.52 | |
Cigna
| Professional | $234.42 | $234.42 | $288.40 | |
Medica
| Facility | $29.51 | $50.12 | $81.28 | |
Wellmark
| Professional | $27.54 | $27.54 | $27.54 |