| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $234.48 | $404.13 | $404.13 | |
Cigna
| Professional | $104.51 | $104.51 | $104.51 | |
Medica
| Facility | $234.48 | $396.27 | $682.98 | |
Wellmark
| Professional | $847.90 | $847.90 | $847.90 |