| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.02 | $57.02 | $57.02 | |
Aetna
| Professional | $5.00 | $12.00 | $27.50 | |
Anthem BCBS
| Professional | $5.00 | $5.00 | $5.00 | |
Cigna
| Professional | $94.74 | $201.47 | $255.12 | |
Medica
| Facility | $6.17 | $7.26 | $7.99 |