| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $48.75 | $48.75 | $122.46 | |
BCBS
| Professional | $156.18 | $189.31 | $205.88 | |
Cigna
| Professional | $207.00 | $475.66 | $751.00 | |
Medica
| Facility | $48.75 | $122.46 | $208.00 | |
Medica
| Professional | $901.00 | $901.00 | $901.00 |