| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.54 | $144.54 | $144.54 | |
Aetna
| Professional | $114.82 | $120.23 | $138.04 | |
BCBS
| Facility | $1.00 | $1.00 | $1.00 | |
BCBS
| Professional | $177.83 | $208.93 | $363.08 | |
Cigna
| Facility | $123.03 | $123.03 | $123.03 | |
Medica
| Facility | $114.82 | $144.54 | $263.03 |