| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.86 | $128.86 | $128.86 | |
Aetna
| Professional | $20.00 | $60.00 | $128.86 | |
BCBS
| Professional | $23.53 | $29.01 | $42.06 | |
Cigna
| Professional | $51.00 | $95.00 | $154.65 | |
Medica
| Facility | $20.00 | $128.86 | $195.87 | |
Medica
| Professional | $515.64 | $515.64 | $515.64 |