| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
BCBS
| Professional | $25.00 | $25.00 | $25.00 | |
Cigna
| Professional | $3.60 | $3.60 | $3.60 | |
Medica
| Facility | $20.00 | $20.00 | $25.00 |