| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $3.00 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
BCBS
| Facility | $1.00 | $23.25 | $136.86 | |
BCBS
| Professional | $18.60 | $22.55 | $23.25 | |
Cigna
| Professional | $8.50 | $8.50 | $8.50 | |
Medica
| Facility | $3.00 | $3.00 | $5.40 |