| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $225.00 | $225.00 | $556.63 | |
Aetna
| Professional | $225.00 | $362.81 | $743.15 | |
BCBS
| Professional | $572.05 | $671.34 | $676.35 | |
Cigna
| Professional | $104.49 | $105.53 | $132.69 | |
Medica
| Facility | $225.00 | $225.00 | $382.50 |