| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $75.00 | |
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
Anthem BCBS
| Professional | $48.67 | $187.00 | $187.00 | |
Cigna
| Professional | $98.27 | $98.27 | $98.27 | |
Medica
| Facility | $75.00 | $86.25 | $168.00 | |
Medica
| Professional | $188.44 | $188.44 | $188.44 |