| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.43 | $183.28 | $183.28 | |
Cigna
| Facility | $228.57 | $228.57 | $228.57 | |
Cigna
| Professional | $99.89 | $228.57 | $228.57 | |
Medica
| Facility | $33.79 | $33.79 | $100.00 | |
Medica
| Professional | $34.15 | $191.66 | $505.20 |