| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
BCBS
| Facility | $23.56 | $85.11 | $153.88 | |
BCBS
| Professional | $58.91 | $78.54 | $107.02 | |
Cigna
| Facility | $32.74 | $32.74 | $32.74 | |
Cigna
| Professional | $23.90 | $23.90 | $32.74 | |
Medica
| Facility | $25.00 | $25.00 | $90.00 | |
Medica
| Professional | $25.00 | $25.00 | $78.59 |