| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.72 | $166.38 | $471.42 | |
Aetna
| Professional | $96.72 | $96.72 | $96.72 | |
Anthem BCBS
| Professional | $100.00 | $100.00 | $125.97 | |
Cigna
| Professional | $58.65 | $58.65 | $58.65 | |
Medica
| Facility | $96.72 | $139.18 | $213.75 |