| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.49 | $34.49 | $34.49 | |
Aetna
| Professional | $34.49 | $34.49 | $34.49 | |
Anthem BCBS
| Professional | $22.73 | $22.73 | $52.00 | |
Cigna
| Professional | $2.02 | $2.02 | $2.02 | |
Medica
| Facility | $34.49 | $34.49 | $950.51 | |
Medica
| Professional | $122.28 | $122.28 | $122.28 |