| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8.63 | $25.41 | $132.38 | |
Aetna
| Professional | $13.50 | $26.40 | $40.00 | |
Cigna
| Professional | $13.25 | $13.25 | $13.25 | |
Medica
| Facility | $8.11 | $52.20 | $495.06 | |
Medica
| Professional | $24.00 | $148.18 | $408.60 |