| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.72 | $96.72 | $96.72 | |
Aetna
| Professional | $96.72 | $96.72 | $96.72 | |
BCBS
| Facility | $49.00 | $64.29 | $103.29 | |
Cigna
| Professional | $58.65 | $58.65 | $58.65 | |
Medica
| Facility | $96.72 | $111.23 | $154.75 |