| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.02 | $3.02 | $3.02 | |
Aetna
| Professional | $3.02 | $3.02 | $3.02 | |
BCBS
| Facility | $23.44 | $95.50 | $229.09 | |
BCBS
| Professional | $18.62 | $23.44 | $23.44 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $8.51 | $8.51 | $8.51 | |
Medica
| Facility | $3.02 | $3.02 | $100.00 |