| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $136.08 | $136.08 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
BCBS
| Facility | $26.58 | $29.54 | $33.93 | |
BCBS
| Professional | $30.30 | $30.30 | $30.60 | |
Cigna
| Professional | $28.91 | $28.91 | $28.91 | |
Medica
| Facility | $20.00 | $20.81 | $56.20 | |
Medica
| Professional | $22.50 | $22.50 | $22.50 |