| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.88 | $239.88 | $239.88 | |
Aetna
| Professional | $239.88 | $239.88 | $660.69 | |
BCBS
| Facility | $1.00 | $1.00 | $1.00 | |
BCBS
| Professional | $177.83 | $208.93 | $363.08 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Medica
| Facility | $100.00 | $239.88 | $660.69 |