| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.88 | $132.88 | $132.88 | |
Aetna
| Professional | $132.88 | $132.88 | $132.88 | |
Anthem BCBS
| Professional | $11.44 | $150.00 | $228.75 | |
Cigna
| Facility | $54.70 | $88.60 | $172.68 | |
Medica
| Facility | $132.88 | $132.88 | $344.54 |