| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.59 | $11.48 | $181.97 | |
Aetna
| Facility | 25 | $154.88 | $346.74 | $426.58 |
BCBS
| Facility | $162.18 | $169.82 | $169.82 | |
Cigna
| Facility | $812.83 | $812.83 | $812.83 | |
Medica
| Facility | $10.47 | $25.70 | $60.26 |