| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.28 | $81.56 | $81.56 | |
Aetna
| Professional | $80.78 | $81.56 | $81.56 | |
Cigna
| Professional | $46.50 | $46.50 | $58.13 | |
Medica
| Facility | $40.11 | $78.43 | $138.66 | |
Medica
| Professional | $40.11 | $40.11 | $40.11 |