| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.15 | $37.15 | $37.15 | |
Aetna
| Professional | $37.15 | $37.15 | $37.15 | |
BCBS
| Professional | $43.37 | $43.37 | $43.37 | |
Cigna
| Professional | $19.36 | $19.36 | $19.36 | |
Medica
| Facility | $37.15 | $38.65 | $100.00 |