| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.31 | $14.31 | $14.31 | |
Aetna
| Professional | $13.84 | $15.54 | $19.77 | |
Cigna
| Professional | $14.83 | $14.83 | $19.22 | |
Medica
| Facility | $14.31 | $17.45 | $30.28 | |
Medica
| Professional | $108.59 | $108.59 | $108.59 |