| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.44 | $114.82 | $114.82 | |
Aetna
| Professional | $69.18 | $81.28 | $114.82 | |
Cigna
| Professional | $79.43 | $79.43 | $100.00 | |
Medica
| Facility | $69.18 | $120.23 | $194.98 | |
Medica
| Professional | $69.18 | $69.18 | $69.18 |