| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.14 | $112.20 | $239.88 | |
Cigna
| Professional | $154.88 | $154.88 | $154.88 | |
Medica
| Facility | $27.54 | $141.25 | $147.91 | |
Wellmark
| Professional | $107.15 | $107.15 | $107.15 |