| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $234.42 | $407.38 | $407.38 | |
Cigna
| Professional | $104.71 | $104.71 | $104.71 | |
Medica
| Facility | $234.42 | $407.38 | $1,047.13 | |
Wellmark
| Professional | $851.14 | $851.14 | $851.14 |