| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.58 | $56.58 | $56.58 | |
Aetna
| Professional | $40.71 | $56.58 | $105.84 | |
Cigna
| Professional | $48.75 | $49.24 | $60.94 | |
Medica
| Facility | $42.13 | $68.80 | $111.55 | |
Medica
| Professional | $42.13 | $42.13 | $42.13 |