| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $14.82 | |
Aetna
| Professional | $14.82 | $14.82 | $14.82 | |
BCBS
| Facility | $69.69 | $76.27 | $1,865.44 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 | |
Medica
| Facility | $14.82 | $25.05 | $230.57 |