| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $363.08 | $537.03 | |
Aetna
| Professional | $114.82 | $114.82 | $114.82 | |
BCBS
| Facility | $154.88 | $204.17 | $223.87 | |
BCBS
| Professional | $489.78 | $489.78 | $489.78 | |
Cigna
| Professional | $79.43 | $79.43 | $79.43 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |