| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.00 | $4.00 | $4.00 | |
Aetna
| Professional | $4.00 | $4.00 | $4.00 | |
BCBS
| Facility | $1.00 | $11.96 | $70.40 | |
BCBS
| Professional | $9.57 | $11.60 | $11.96 | |
Cigna
| Professional | $1.76 | $1.76 | $1.76 | |
Medica
| Facility | $4.00 | $4.00 | $7.20 |