| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.98 | $3.98 | $3.98 | |
Aetna
| Professional | $3.98 | $3.98 | $3.98 | |
BCBS
| Facility | $12.02 | $48.98 | $117.49 | |
BCBS
| Professional | $9.55 | $12.02 | $12.02 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $1.78 | $1.78 | $1.78 | |
Medica
| Facility | $3.98 | $3.98 | $100.00 |