| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.78 | $23.78 | $23.78 | |
Aetna
| Professional | $20.21 | $23.78 | $23.78 | |
Cigna
| Facility | $19.44 | $19.44 | $19.44 | |
Medica
| Facility | $18.85 | $36.17 | $42.80 | |
Medica
| Professional | $90.36 | $90.36 | $90.36 |