| 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 | $15.81 | $15.81 | $15.81 | |
BCBS
| Professional | $15.81 | $15.81 | $15.81 | |
Cigna
| Professional | $28.91 | $28.91 | $28.91 | |
Medica
| Facility | $20.00 | $20.00 | $24.60 |